Gut Liver.  2016 Jan;10(1):69-75. 10.5009/gnl14372.

Does Helicobacter pylori Exacerbate Gastric Mucosal Injury in Users of Nonsteroidal Anti-Inflammatory Drugs? A Multicenter, Retrospective, Case-Control Study

• Kono Y
• Okada H
• Takenaka R
• Miura K
• Kanzaki H
• Hori K
• Kita M
• Tsuzuki T
• Kawano S
• Kawahara Y
• Yamamoto K

• KMID: 2382346
• DOI: http://doi.org/10.5009/gnl14372

Abstract

BACKGROUND/AIMS
The interaction between nonsteroidal anti-inflammatory drugs (NSAIDs) and Helicobacter pylori remains controversial. We retrospectively investigated whether H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.
METHODS
From January 2010 to December 2013, a total of 245 long-term NSAID (including low-dose aspirin) users who had undergone an esophagogastroduodenoscopy and had been evaluated for H. pylori infection were enrolled at Okayama University Hospital and Tsuyama Chuo Hospital. The degree of gastric mucosal injury was assessed according to the modified Lanza score (MLS). Severe gastric mucosal injury was defined as an MLS > or =4. Univariate and multivariate logistic regression analyses were performed.
RESULTS
In the univariate analysis, age > or =75 years (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.3 to 4.2), H. pylori-positivity (OR, 2.0; 95% CI, 1.2 to 3.5), and the concomitant use of proton pump inhibitors (PPIs) (OR, 0.48; 95% CI, 0.26 to 0.86) were significantly associated with severe gastric mucosal injury. The multivariate analysis was adjusted by age and sex and demonstrated that H. pylori-positivity (OR, 1.8; 95% CI, 1.0 to 3.3) and the concomitant use of PPIs (OR, 0.53; 95% CI, 0.28 to 0.99) significantly contributed to severe gastric mucosal injury.
CONCLUSIONS
H. pylori infection exacerbates severe gastric mucosal injury among chronic NSAID users.

Keyword

Anti-inflammatory agents; non-steroidal; Helico-bacter pylori; Gastric mucosal injury; Proton pump inhibitors

MeSH Terms

Aged
Anti-Inflammatory Agents, Non-Steroidal/*adverse effects
Case-Control Studies
*Disease Progression
Endoscopy, Digestive System
Female
Gastric Mucosa/*drug effects/*microbiology
Helicobacter Infections/*complications/microbiology/pathology
*Helicobacter pylori/drug effects
Humans
Logistic Models
Male
Middle Aged
Odds Ratio
Proton Pump Inhibitors/adverse effects
Retrospective Studies
Anti-Inflammatory Agents, Non-Steroidal
Proton Pump Inhibitors