Prevalence of Helicobacter pylori infection and correlation between severity of upper gastrointestinal lesions and H-pylori infection in Japanese patients with Crohn's disease

Background. The prevalence of Helicobacter pylori infection in Crohn's dise ase (CD) patients was investigated to determine whether the presence and se verity of gastroduodenal lesions were related to H. pylori infection. Metho ds. Infection rates were compared between CD group (n = 90) and the control group (n = 525). Correlations between endoscopically detected lesions and H. pylori positive rates were investigated. The relationship between drug t herapy and the prevalence of H. pylori infection was also analyzed. Results . H. pylori-positive rate of the 90 CD patients attending our clinic was 16 .7%. significantly lower than the rate in healthy controls (40.2%) (P = 0.0 001). The involvement of H. pylori infection in the gastroduodenal lesions of CD patients was also examined. The prevalence of gastroduodenal lesions in all CD patients was high, 92.2%. The lesions observed included ulcers, e rosion. and "bamboo joint-like lesions" of the stomach, and ulcers, erosion , stenosis, and elevated lesions of the duodenum. None of these lesions wer e found to be related to H. pylori infection. However, H. pylori infection was found to exacerbate gastric ulcers (P = 0.036). The analysis of a possi ble relationship between a history of drug therapy and the low prevalence o f H. pylori infection in CD patients showed that the prevalence of H. pylor i infection was significantly lower in patients who had received antibiotic s for 2 weeks or more (P = 0.002). Conclusions. The results suggest that H. pylori infection is essentially unrelated to the gastroduodenal lesions ob served in CD. It seems likely, however, that H. pylori infection may exacer bate gastric ulcers and that H. pylori can be eradicated by prolonged use o f antibiotics.