Helicobacter pylori ve inflamatuvar bağırsak hastalığı arasındaki ilişki

Abstract

ak ad em ik g as tr o en te ro lo ji d er g is i 2 02 1; 2 0( 2) : 6 569 Background and Aims: It has been suggested that chronic Helicobacter pylori infection plays a protective role against inflammatory bowel disease by inducing systemic immune tolerance and suppressing inflammatory responses. The primary aim of the study was to determine the frequency of Helicobacter pylori in inflammatory bowel disease patients. A secondary aim was to investigate the relationship between inflammatory bowel disease and Helicobacter pylori infection. Materials and Methods: Patients over 18 years of age who were in follow-up with a diagnosis of inflammatory bowel disease and who underwent upper gastrointestinal system endoscopy for dyspepsia were included in the study and their data retrospectively analyzed. The control group consisted of patients who were not diagnosed with inflammatory bowel disease and had upper gastrointestinal system endoscopy for dyspepsia. For all patients, age; gender; and the presence of Helicobacter pylori, atrophic gastritis, and intestinal metaplasia as a result of pathological evaluation of biopsy samples taken by upper gastrointestinal system endoscopy were recorded. Both groups were compared in terms of Helicobacter pylori frequency and histopathological findings (presence of intestinal metaplasia and atrophic gastritis). Results: A total of 220 cases, including 160 inflammatory bowel disease and 60 controls, were included in the study. In all, 53.8% (n = 86) of inflammatory bowel disease patients were diagnosed with ulcerative colitis and 46.2% (n = 74) with Crohn’s disease. The rate of Helicobacter pylori was found to be significantly lower in the inflammatory bowel disease group compared with the control group (52.5% versus 73.3% and p = 0.005). The rate of atrophic gastritis was significantly lower in the inflammatory bowel disease group compared with the control group (3.1% vs 15% and p = 0.001). The intestinal metaplasia rate was significantly lower in the inflammatory bowel disease group compared with the control group (1.9% vs 11.7% and p = 0.002). Conclusion: Helicobacter pylori positivity was found at a significantly lower rate in the inflammatory bowel disease group. The presence of atrophic gastritis and intestinal metaplasia was found to be lower in the inflammatory bowel disease group. We believe that antibiotics used in the routine treatment of inflammatory bowel disease patients decrease the frequency of Helicobacter pylori and lead to less frequent development of atrophic gastritis and intestinal metaplasia.