Helicobacter pylori increases the risk of peptic ulcer bleeding: a case-control study

Aim of the present case-control study was to establish whether Helicobacter pylori increases the risk of ulcer bleeding. Patients and Methods. All patients presenting with upper gastrointestinal b leeding between November 1994 and November 1995 were prospectively investig ated and compared with hospital controls matched for age, sex, and race. We evaluated the frequency of Helicobacter pylori infection, intake of aspiri n or non-steroidal anti-inflammatory; drugs, use of alcohol, and smoking ha bits in patients and controls. Results. Included in the study were 128 patients. In 72 patients, the sourc e of bleeding was a peptic ulcer (duodenal ulcer: n = 33; gastric ulcer: n = 39). Ulcer patients were more frequently infected by Helicobacter pylori than controls (72% vs 42%; p<0.001) while the incidence of infection was si milar in patients with non-ulcer bleeding and controls (52% vs 46%; p=0.59) . Conditional multiple logistic regression analysis showed that Helicobacte r pylori infection odds ratio, 3.3 [Confidence interval, 1.5 to 7.0]; p=0.0 02 and regular use of alcohol odds ratio, 3.1 [Confidence interval, 1.0 to 9.0]; p=0.041 increased the risk of peptic ulcer bleeding while previous in take of aspirin (> 100 mg) or non-steroidal anti-inflammatory drugs indepen dently increased the risk of bleeding only in the case of gastric ulcer (od ds ratio, 8.1 Confidence interval 1.2 to 56.6; p=0.034). Conclusions. Helicobacter pylori infection increases the risk of peptic ulc er bleeding. Our results suggest that Helicobacter pylori and non-steroidal anti-inflammatory drugs are independent risk factors for peptic ulcer blee ding.