HELICOBACTER-PYLORI INFECTION INCREASES THE RISK OF PEPTIC-ULCERS IN CHRONIC USERS OF NONSTEROIDAL ANTIINFLAMMATORY DRUGS

The objective was to study the gastrointestinal complications in chron ic NSAID users with Helicobacter pylori infection. Eighty-two Chinese patients on long-term NSAID or aspirin treatment were studied for the occurrence of H. pylori infection and gastroduodenal mucosal injuries by upper endoscopy. H. pylori infection was confirmed by CLO test, his tology and bacteriological cultures. Frequency and severity of symptom s of dyspepsia were also assessed. Thirty-three (40%) patients were di agnosed to have H. pylori infection and 49 (60%) patients were not inf ected. The two groups were comparable in age, sex, smoking and drinkin g habit and the use of anti-ulcer drugs. Twenty-four out of 33 (72.7%) H. pylori-positive patients and 31 out of 49 (63%) of H. pylori-negat ive patients were found to have macroscopic lesions by endoscopy. The overall incidence of gastroduodenal lesions in the H. pylori positive patients was not significantly different from the H. pylori-negative p atients (p=0.34). However a higher incidence of duodenal ulcers in the H. pylori-infected group than the H. pylori-negative group (33% vs 6% , p=0.0001) was found. The difference in severity and frequency of dys peptic symptoms between the two groups did not reach statistical signi ficance. H. pylori infected chronic NSAID users is associated with a h igher rate of duodenal ulcer.