Assessment of the prevalence of infection with Helicobacter pylori in patients with inflammatory bowel disease

Objective To determine the prevalence of Helicobacter pylori in patients wi th inflammatory bowel disease (IBD) and compare this to the prevalence in a control population with non-organic bowel symptoms, and to investigate the effect of sulphasalazine and other 5-aminosalicylic acid (5-ASA) drugs on the prevalence of H. pylori in IBD patients. Design Prospective, controlled trial. Setting Gastroenterology out-patient department, City General Hospital, Nor th Staffordshire Hospitals NHS Trust, Stoke-on-Trent. Participants The population comprised 51 patients with ulcerative colitis, 42 patients with Crohn's disease and 40 patients with irritable bowel syndr ome as controls. Patients with X-ray- and/or biopsy-proven disease were eli gible to be entered into the study. Interventions Subjects filled in a detailed questionnaire, were assessed fo r seropositivity of H. pylori and underwent a C13 urea breath test (UBT). Main outcome measures Seropositivity for H. pylori and a positive C13 UBT r esult. Results A quarter of the irritable bowel syndrome controls were seropositiv e for H. pylori. Of the ulcerative colitis patients, 21.6% were currently H . pylori-positive on C13 UBT; 17.6% of the ulcerative colitis patients who had been previously treated with sulphasalazine were positive while 23.1% o f the ulcerative colitis patients who had been treated with a non-sulphasal azine 5-ASA drug were positive. Of the Crohn's patients, 11.9% were current ly H. pylori-positive; 3.6% of the Crohn's patients who had been previously treated with sulphasalazine were positive while 12.5% of the Crohn's patie nts who had been treated with a non-sulphasalazine 5-ASA drug were positive . Conclusions Patients with IBD and Crohn's disease in particular were less l ikely to be H. pylori-positive than controls. Sulphasalazine treatment furt her decreased the prevalence of H. pylori, although the reduced prevalence of H. pylori in IBD patients could not be accounted for by this alone. (C) 2000 Lippincott Williams & Wilkins.