The Effect of Helicobacter pylori Infection on Peptic Ulcer Bleeding

Kim, Hak Yang; Kim, Yong Bum; Jang, Myoung Kuk; Lee, Ja Young; Lee, Jun Ho; Kim, Sung Gyun; Rho, Byeong Yeon; Choi, Jong Hyoung; Seo, Ji Young; Kim, Jai Sam; Kim, Jong Hyeoi

Abstract

BACKGROUND AND AIMS: The aim of the present study was to determine whether Helicobacter pylori infections are related to the risk of bleeding complications of peptic ulcer disease.
METHODS
We have examined 267 patients with symptoms and endoscopic stigmata of recent ulcer bleeding. The severity of ulcer bleeding was categorized by Forrest classification and H. pylori infection was evaluated by CLOtest. The H. pylori infection rates of the patients group were cornpared with those having uncomplicated peptic ulcer.
RESULTS
The positive rate of H. pylori infection in total patients with bleeding ulcer was 65.2% (174 of 267), which was significantly lower than that of patients with non-bleeding ulcer 72.6% (748 of 1031)(p<0.05, OR;0.708, 95%, CI;0.532-0.943). However, in subgroup analysis, the positive rates of CLOtest in patients with bleeding gastric ulcer (GU) and duodenal ulcer (DU) were 59.0% (98/166) and 76.1% (70/92), respectively. These data are similar to the rates obtained from those with uncomplicated ulcers, 66.1% (302/457) in GU, and 79.3% (367/463) in DU, respectively (p=0.105, p=0.496). In the subgroups of Forrest Ia and Ib, 20 out of 21 patients (95.2%) were infected by H. pylori, and their infection rate was significantly higher than that of total patients (p<0.05).
CONCLUSIONS
Our results suggested that H. pylori infection was not a risk factor of bleeding complications of peptic ulcer. However, the subgroup of active ulcer bleeding, Forrest Ia and Ib could be associated with H. pylori infection.