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Taylor CS, McMahon MV, Ward ZJ, Alarid-Escudero F, Camargo MC, Laszkowska M, Roa J, Yeh JM. Birth cohort and age-specific trends in global Helicobacter pylori seroprevalence: a scoping review. LANCET REGIONAL HEALTH. AMERICAS 2025; 41:100877. [PMID: 40321652 PMCID: PMC12049731 DOI: 10.1016/j.lana.2024.100877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 06/27/2024] [Accepted: 08/13/2024] [Indexed: 05/08/2025]
Abstract
Gastric cancer persists around the world as one of the leading causes of cancer-related death, despite declines in recent years. The declining prevalence of H pylori, the primary risk factor for gastric cancer, has contributed to this reduction and understanding changes in seroprevalence trends over time may yield further insight into gastric cancer incidence trends. We conducted a scoping review to compile data on H pylori seroprevalence in asymptomatic populations to assess global trends by age and birth cohort. We found that published data suggest H pylori seroprevalence declined among recent birth cohorts and increased with age, with trends differing between regions and sub-regions subject to data availability. The Americas lacked sufficient data to enable more robust assessment of H pylori trends by both age and birth cohort. Funding NCI: U01CA265729, P30 CA008748; NIDDK: K08 DK125876.
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Affiliation(s)
- Chelsea S. Taylor
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | | | - Zachary J. Ward
- Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Fernando Alarid-Escudero
- Center for Health Policy, Department of Health Policy, Freeman Spogli Institute, School of Medicine, Stanford University, CA, USA
| | - M. Constanza Camargo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, 20850, USA
| | - Monika Laszkowska
- Gastroenterology, Hepatology, and Nutrition Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jorge Roa
- Data Science Lab, Hertie School, Berlin, Germany
| | - Jennifer M. Yeh
- Division of General Pediatrics, Boston Children's Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Harvard University, Boston, MA, USA
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Birato YC, Armand Masimango B, Katabana DM, Shindano TA. Risk factors of Helicobacter pylori infection in Bukavu, Democratic Republic of the Congo: a case-control study. Ann Med Surg (Lond) 2023; 85:727-731. [PMID: 37113886 PMCID: PMC10129276 DOI: 10.1097/ms9.0000000000000409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 03/07/2023] [Indexed: 04/29/2023] Open
Abstract
Helicobacter pylori (H. pylori) is the common etiology of gastric tumors. This study aimed to evaluate the risk factors associated with H. pylori infection in the eastern part of the Democratic Republic of the Congo (DR Congo), where these tumors seem to be more frequent than in its western part. Patients and Methods Between January and December 2021, the authors conducted a multicenter case-control study in three hospitals in Bukavu City involving 90 individuals with dyspeptic complaints. Risk factors for H. pylori infection were assessed in a participant interview and H. pylori status from stool antigen detection. Results Among the risk factors assessed, only history of H. pylori in the family and the habit of adding salt to already-seasoned food were found positively associated with the risk of H. pylori infection (adjusted odds ratio: 7, 95 CI: 2.742-17.867; P<0.0001 and 2.911, 95% CI: 1.010-8.526; P=0.048, respectively). On the other hand, low-temperature food storage seems to be protective with a negative association (adjusted odds ratio: 0.044, 95% CI: 0.009-0.206; P=0.0001). Conclusion This study demonstrated again the importance of lifestyle-related factors on the risk of acquisition of H. pylori. These findings call for preventive interventions for this group of individuals.
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Affiliation(s)
- Yannick C. Birato
- Faculty of Medicine, Université Officielle de Bukavu
- Department of Internal Medicine, Cliniques Universitaires de Bukavu
- Corresponding author. Address: Department of Internal Medicine, Faculty of Medicine, Official University of Bukavu, Bukavu, 571 Cyangugu, The Democratic Republic of the Congo. Tel: +243 978 130 782. E-mail address: (Y.C. Birato)
| | | | - Delphin M. Katabana
- Faculty of Medicine, Université Officielle de Bukavu
- Department of Internal Medicine, Cliniques Universitaires de Bukavu
| | - Tony A. Shindano
- Faculty of Medicine, Université Officielle de Bukavu
- Department of Internal Medicine, Cliniques Universitaires de Bukavu
- Department of Internal Medicine, Hôpital Provincial Général de Référence de Bukavu (HPGRB)
- Faculty of Medicine, Université Catholique de Bukavu (UCB), Bukavu
- University of Kindu, Kindu, Maniema, DR Congo
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Sardar M, Kumar D, Aakash FNU, Partab FNU, Kumar S, Barkha FNU, Danesh FNU, Berza Q, Shaikh B, Sangam FNU, Hasan M, Erum S, Mumtaz H. Prevalence and etiology of Helicobacter pylori infection in dyspepsia patients: a hospital-based cross-sectional study. Ann Med Surg (Lond) 2023; 85:665-669. [PMID: 37113856 PMCID: PMC10129114 DOI: 10.1097/ms9.0000000000000120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 12/22/2022] [Indexed: 04/05/2023] Open
Abstract
Helicobacter pylori infection is seropositive in ~50% of people globally. Therefore, this study was conducted to evaluate its prevalence in dyspepsia patients. Methods A cross-sectional study was conducted at Jinnah Postgraduate Medical Centre (JPMC) from January to June 2022 to find out the prevalence and risk factors of H. pylori in dyspepsia patients. A prevalidated questionnaire was used to collect the data from 180 patients. This study adheres to the principles outlined in the Helsinki Declaration. The χ 2-test was applied, and the odds ratio and 95% CI were calculated to find the association of H. pylori with the risk factors. Results A total of 180 patients were enrolled in this study, of whom, 73 (40.6%) patients were male and 107 (59.4%) were female. In seropositive H. pylori patients, 80 (60.6%) patients had nausea or vomiting, 110 (83.3%) patients were found to have flatulence, 128 (97.7%) patients were experiencing frequent burping, and 114 (86.4%) patients were having epigastric pain. The household member greater than 4, smoking, rural area residence, NSAIDs consumption, BMI greater than 25, O+ blood group, and Rhesus positive status were significantly associated with H. pylori with a P value of less than 0.05. Conclusion This study concludes that the prevalence of H. pylori in our population is high, and the risk factors identified are lower class, BMI greater than 25, smoking, O+ blood group, NSAID consumption, rural area residence, household member greater than 4, Rhesus positive status, and the symptoms of nausea or vomiting, frequent burping, epigastric pain, and flatulence. Patients with an increased number of risk factors should be taken into consideration for an appropriate checkup.
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Affiliation(s)
| | | | | | - FNU Partab
- Jinnah Postgraduate Medical Centre (JPMC)
| | | | - FNU Barkha
- Department of Internal Medicine, Dow Medical College, Civil Hospital
| | | | | | - Bisma Shaikh
- Liaqat University of Medical and Health Sciences
| | - FNU Sangam
- Liaqat University of Medical and Health Sciences
- Liaquat University of Medical and Health Sciences, Jamshoro
| | | | - Sheeza Erum
- Maroof International Hospital Health Services Academy, Islamabad, Pakistan
| | - Hassan Mumtaz
- Maroof International Hospital Health Services Academy, Islamabad, Pakistan
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Suzuki N, Nakano Y, Yoneda M, Hirofuji T, Hanioka T. The effects of cigarette smoking on the salivary and tongue microbiome. Clin Exp Dent Res 2021; 8:449-456. [PMID: 34505401 PMCID: PMC8874080 DOI: 10.1002/cre2.489] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/10/2021] [Accepted: 08/23/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives It has been suggested that smoking affects the oral microbiome, but its effects on sites other than the subgingival microbiome remain unclear. This study investigated the composition of the salivary and tongue bacterial communities of smokers and nonsmokers in periodontally healthy adults. Methods The study population included 50 healthy adults. The bacterial composition of resting saliva and the tongue coating was identified through barcoded pyrosequencing analysis of the 16S rRNA gene. The Brinkman index (BI) was used to calculate lifetime exposure to smoking. The richness and diversity of the microbiome were evaluated using the t‐test. Differences in the proportions of bacterial genera between smokers and nonsmokers were evaluated using the Mann–Whitney U test. The quantitative relationship between the proportions of genera and the BI was evaluated using Pearson's correlation analysis. Results The richness and diversity of the oral microbiome differed significantly between saliva and the tongue but not between smokers and nonsmokers. The saliva samples from smokers were enriched with the genera Treponema and Selenomonas. The tongue samples from smokers were enriched with the genera Dialister and Atopobium. The genus Cardiobacterium in saliva, and the genus Granulicatella on the tongue, were negatively correlated with BI values. On the other hand, the genera Treponema, Oribacterium, Dialister, Filifactor, Veillonella, and Selenomonas in saliva and Dialister, Bifidobacterium, Megasphaera, Mitsuokella, and Cryptobacterium on the tongue were positively correlated with BI values. Conclusions The saliva and tongue microbial profiles of smokers and nonsmokers differed in periodontally healthy adults. The genera associated with periodontitis and oral malodor accounted for high proportions in saliva and on the tongue of smokers without periodontitis and were positively correlated with lifetime exposure to smoking. The tongue might be a reservoir of pathogens associated with oral disease in smokers.
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Affiliation(s)
- Nao Suzuki
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan.,Oral Medicine Research Center, Fukuoka Dental College, Fukuoka, Japan
| | - Yoshio Nakano
- Department of Chemistry, Nihon University School of Dentistry, Tokyo, Japan
| | - Masahiro Yoneda
- Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Takao Hirofuji
- Department of General Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - Takashi Hanioka
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
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Ferro A, Morais S, Pelucchi C, Aragonés N, Kogevinas M, López-Carrillo L, Malekzadeh R, Tsugane S, Hamada GS, Hidaka A, Hernández-Ramírez RU, López-Cervantes M, Zaridze D, Maximovitch D, Pourfarzi F, Zhang ZF, Yu GP, Pakseresht M, Ye W, Plymoth A, Leja M, Gasenko E, Derakhshan MH, Negri E, La Vecchia C, Peleteiro B, Lunet N. Smoking and Helicobacter pylori infection: an individual participant pooled analysis (Stomach Cancer Pooling- StoP Project). Eur J Cancer Prev 2019; 28:390-396. [PMID: 30272597 DOI: 10.1097/cej.0000000000000471] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Smoking has been associated with acquisition and increased persistence of Helicobacter pylori infection, as well as with lower effectiveness of its eradication. A greater prevalence of infection among smokers could contribute to the increased risk for gastric cancer. We aimed to estimate the association between smoking and seropositivity to H. pylori through an individual participant data pooled analysis using controls from 14 case-control studies participating in the Stomach Cancer Pooling Project. Summary odds ratios and prevalence ratios (PRs), adjusted for age, sex and social class, and the corresponding 95% confidence intervals (CIs) were estimated through random-effects meta-analysis. Heterogeneity was quantified using the I statistic and publication bias with Egger's test. There was no significant association between smoking (ever vs. never) and H. pylori seropositivity (adjusted odds ratio = 1.08; 95% CI: 0.89-1.32; adjusted PR = 1.01; 95% CI: 0.98-1.05). The strength of the association did not increase with the intensity or duration of smoking; stratified analyses according to sex, age, region or type of sample did not yield a consistent pattern of variation or statistically significant results, except for participants younger than 55 years and who had been smoking for more than 30 years (adjusted PR = 1.08; 95% CI: 1.02-1.15). This is the first collaborative analysis providing pooled estimates for the association between smoking and H. pylori seropositivity, based on detailed and uniform information and adjusting for major covariates. The results do not support an association between smoking and H. pylori infection.
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Affiliation(s)
- Ana Ferro
- EPIUnit - Instituto de Saúde Pública
| | | | | | - Nuria Aragonés
- Department of Health of Madrid, Epidemiology Section, Public Health Division
- CIBER Epidemiología y Salud Pública, Madrid, Spain
| | - Manolis Kogevinas
- CIBER Epidemiología y Salud Pública, Madrid, Spain
- ISGlobal, Centre for Research in Environmental Epidemiology
- IMIM (Hospital del Mar Medical Research Institute)
- Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Reza Malekzadeh
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran
| | - Shoichiro Tsugane
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | | | - Akihisa Hidaka
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Raúl U Hernández-Ramírez
- Mexico National Institute of Public Health, Morelos
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale School of Medicine, New Haven, USA
| | | | - David Zaridze
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Dmitry Maximovitch
- Department of Epidemiology and Prevention, Russian N.N. Blokhin Cancer Research Center, Moscow, Russia
| | - Farhad Pourfarzi
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran
- Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Zuo-Feng Zhang
- Department of Epidemiology, UCLA Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
| | - Guo-Pei Yu
- Medical Informatics Center, Peking University, Peking, China
| | - Mohammadreza Pakseresht
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran
- Department of Agricultural, Food and Nutritional Sciences, University of Alberta, Edmonton, Alberta, Canada
- Nutritional Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amelie Plymoth
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marcis Leja
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, Riga
| | - Evita Gasenko
- Institute of Clinical and Preventive Medicine, Faculty of Medicine, University of Latvia, Riga
| | - Mohammad H Derakhshan
- Digestive Oncology Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, UK
| | - Eva Negri
- Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | | | - Bárbara Peleteiro
- EPIUnit - Instituto de Saúde Pública
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública
- Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Evandrou M, Falkingham J, Qin M, Vlachantoni A. Children's migration and chronic illness among older parents 'left behind' in China. SSM Popul Health 2017; 3:803-807. [PMID: 29349265 PMCID: PMC5769113 DOI: 10.1016/j.ssmph.2017.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 10/06/2017] [Accepted: 10/07/2017] [Indexed: 12/20/2022] Open
Abstract
The relationship between adult children's migration and the health of their older parents 'left behind' is an emerging research area and existing studies reflect mixed findings. This study aims to investigate the association between having migrant (adult) children and older parents' chronic illness in China, using chronic stomach or other digestive diseases as a proxy. Secondary analysis of the national baseline survey of the 2011 China Health and Retirement Longitudinal Study (CHARLS) was conducted. Analyses were conducted in a total of sample of 6495 individuals aged 60 years and above from 28 out of 31 provinces in China, who had at least one child at the baseline survey. Binary logistic regression was used. The prevalence of any of the diagnosed conditions of chronic stomach or other digestive diseases was higher among older people with a migrant son than among those without (27 percent vs 21 percent, p < 0.001). More specifically, the odds ratio of reporting a disease was higher among older adults with at least one adult son living in another county or province than among those with all their sons living closer (OR = 1.29, 95% CI = 1.10-1.51). The results from this large sample of older adults support the hypothesis that migration of sons significantly increases the risk of chronic stomach and other digestive diseases among 'left behind' elderly parents in contemporary China.
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Affiliation(s)
| | | | - Min Qin
- Correspondence to: Centre for Research on Ageing and ESRC Centre for Population Change, University of Southampton, Southampton SO17 1BJ, UK.Centre for Research on Ageing and ESRC Centre for Population Change, University of SouthamptonSouthamptonSO17 1BJUK
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Patel S, Lipka S, Shen H, Barnowsky A, Silpe J, Mosdale J, Pan Q, Fridlyand S, Bhavsar A, Abraham A, Viswanathan P, Mustacchia P, Krishnamachari B. The association of H. pylori and colorectal adenoma: does it exist in the US Hispanic population? J Gastrointest Oncol 2014; 5:463-8. [PMID: 25436126 DOI: 10.3978/j.issn.2078-6891.2014.074] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 08/18/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Although data on the association between colorectal adenomas and Helicobacter pylori (H. pylori) exists in White and Black patients, there is no data on this association in a US Hispanic population. Our aim was to study the association of adenoma detection and biopsy proven H. pylori infection in a cohort of US Hispanics. METHODS Data were collected from Nassau University Medical Center, a 530-bed tertiary care teaching hospital in East Meadow, New York. Patients who underwent both an esophagogastroduodenoscopy (EGD) and colonoscopy from July 2009 to March 2011 were pulled from an electronic database. A total of 1,737 patients completed colonoscopies during this time with 95 excluded: 17 inflammatory bowel disease, 12 malignancy, 22 prior history of colorectal adenoma, and 44 incomplete. Among the colonoscopies, 799 patients had EGD's performed prior to colonoscopies that were eligible for our study. RESULTS H. pylori prevalence was highest in Hispanics 40.9%, followed by Blacks 29.1% (OR 0.59, 95% CI: 0.42-0.84), then Whites 7.9% (OR 0.12, 95% CI: 0.06-0.24). The adenoma detection rate was significantly higher in Whites 23.2% and Blacks 21.8% compared to Hispanics 14.5%, P=0.0002 respectively. Smoking and alcohol were lower in the H. pylori group, 18.6% (n=44) vs. 26.1% (n=147) for smoking (P=0.02) and 14.4% (n=34) vs. 19% (n=107) for alcohol (P=0.12), respectively. There was no evidence in the Hispanics for an association between adenoma detection and H. pylori infection. Furthermore size, location, and multiple polyps did not differ between the two groups. CONCLUSIONS While data has shown an association between H. pylori and colorectal adenomas, we did not find this in our Hispanic population. With the growing population of Hispanics in the U.S, large scale studies are needed to conclusively characterize the role of H. pylori infection in colorectal adenoma and adenocarcinoma in this group of patients.
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Affiliation(s)
- Shruti Patel
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Seth Lipka
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Huafeng Shen
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Alex Barnowsky
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Jeff Silpe
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Josh Mosdale
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Qinshi Pan
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Svetlana Fridlyand
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Anuradha Bhavsar
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Albin Abraham
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Prakash Viswanathan
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Paul Mustacchia
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Bhuma Krishnamachari
- 1 Department of Medicine, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 2 Division of Digestive Diseases and Nutrition, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 3 Department of Medicine, Division of Gastroenterology, Nassau University Medical Center Associated with North Shore-Long Island Jewish Health Care System, East Meadow, NY, USA ; 4 Department of Medicine, Academic Medicine Scholars Program, NYIT College of Osteopathic Medicine, Old Westbury, NY, USA
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8
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Moon JH, Lee JH, Lee JY. Subgingival microbiome in smokers and non-smokers in Korean chronic periodontitis patients. Mol Oral Microbiol 2014; 30:227-41. [PMID: 25283067 DOI: 10.1111/omi.12086] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2014] [Indexed: 11/28/2022]
Abstract
Smoking is a major environmental factor associated with periodontal diseases. However, we still have a very limited understanding of the relationship between smoking and subgingival microflora in the global population. Here, we investigated the composition of subgingival bacterial communities from the pooled plaque samples of smokers and non-smokers, 134 samples in each group, in Korean patients with moderate chronic periodontitis using 16S rRNA gene-based pyrosequencing. A total of 17,927 reads were analyzed and classified into 12 phyla, 126 genera, and 394 species. Differences in bacterial communities between smokers and non-smokers were examined at all phylogenetic levels. The genera Fusobacterium, Fretibacterium, Streptococcus, Veillonella, Corynebacterium, TM7, and Filifactor were abundant in smokers. On the other hand, Prevotella, Campylobacter, Aggregatibacter, Veillonellaceae GQ422718, Haemophilus, and Prevotellaceae were less abundant in smokers. Among species-level taxa occupying > 1% of whole subgingival microbiome of smokers, higher abundance (≥ 2.0-fold compared to non-smokers) of seven species or operational taxonomic units (OTUs) was found: Fusobacterium nucleatum, Neisseria sicca, Neisseria oralis, Corynebacterium matruchotii, Veillonella dispar, Filifactor alocis, and Fretibacterium AY349371. On the other hand, lower abundance of 11 species or OTUs was found in smokers: Neisseria elongata, six Prevotella species or OTUs, Fusobacterium canifelinum, Aggregatibacter AM420165, Selenomonas OTU, and Veillonellaceae GU470897. Species richness and evenness were similar between the groups whereas diversity was greater in smokers than non-smokers. Collectively, the results of the present study indicate that differences exist in the subgingival bacterial community between smoker and non-smoker patients with chronic moderate periodontitis in Korea, suggesting that cigarette smoking considerably affects subgingival bacterial ecology.
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Affiliation(s)
- J-H Moon
- Department of Maxillofacial Biomedical Engineering, School of Dentistry, Institute of Oral Biology, Kyung Hee University, Seoul, Korea; Department of Life and Nanopharmaceutical Sciences, Kyung Hee University, Seoul, Korea
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Hu D, Shao J, Wang L, Zheng H, Xu Y, Song G, Liu Q. Prevalence and risk factors ofHelicobacter pyloriinfection in Chinese maritime workers. Ann Hum Biol 2013; 40:472-6. [DOI: 10.3109/03014460.2013.804121] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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10
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Bureš J, Kopáčová M, Koupil I, Seifert B, Škodová Fendrichová M, Špirková J, Voříšek V, Rejchrt S, Douda T, Král N, Tachecí I. Significant decrease in prevalence of Helicobacter pylori in the Czech Republic. World J Gastroenterol 2012; 18:4412-8. [PMID: 22969207 PMCID: PMC3436059 DOI: 10.3748/wjg.v18.i32.4412] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 08/13/2012] [Accepted: 08/16/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To study possible decrease in prevalence of Helicobacter pylori (H. pylori) infection in the Czech Republic within a 10-year period.
METHODS: A total of 22 centres entered the study. The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants, smaller towns (≤ 20 000 inhabitants) with surrounding villages and rural areas, and were spread over the whole country, corresponding well to the geographical distribution of the Czech population. A total of 1 837 subjects (aged 5-98 years) took part in the study, randomly selected out of 38 147 people from the general population. H. pylori infection was investigated by means of a 13C-urea breath test. Breath samples in duplicates were analysed using isotope ratio mass spectrometry. The cut-off point was 3.5. Social and demographic characteristics were based on data from self-completed questionnaires.
RESULTS: The overall prevalence of H. pylori infection was 23.5% (430/1826), and 4.8% (20/420) in children aged 15 or less. There was no statistically significant difference in prevalence between males (24.3%; 208/857) and females (22.9%, 222/969, P = 0.494). H. pylori infection was strongly associated with higher age, among subjects aged 55+ years, prevalence of H. pylori infection was 39.8% (252/633, P < 0.001). The highest prevalence of H. pylori infection was found among persons aged 55-64 years (43.9%, 97/221) and 75+ years (37.9%, 58/153). Among study subjects aged 15+ years, prevalence of H. pylori infection was significantly increased in those with lowest education (odds risk 3.19, 95% CI 1.87-5.47). Compared to never married (14.1%), the prevalence of H. pylori infection was statistically significantly higher among married (35.4%, 246/694, P < 0.001), divorced (36.8%, 49/133, P < 0.001) and widowed study subjects (40.2%, 45/112, P < 0.001), both in minimally and fully adjusted analysis. There was no significant difference in the prevalence of H. pylori infection between married and widowed subjects (35.4%, 246/694 vs 40.2%, 45/112, P = 0.389). There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk of H. pylori infection among current or past smokers in our data (odds risk 1.04 with 95% CI 0.78-1.40 for current smokers; odds ratio 0.83 with 95% CI 0.60-1.16 for former smokers). The current prevalence of H. pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001 (23.5% vs 41.7%, P < 0.001).
CONCLUSION: The overall prevalence of H. pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.
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Estimating the prevalence of active Helicobacter pylori infection in a rural community with global positioning system technology-assisted sampling. Epidemiol Infect 2012; 141:472-80. [PMID: 22595455 DOI: 10.1017/s0950268812000714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We investigated a possible outbreak of H. pylori in a rural Northern Plains community. In a cross-sectional survey, we randomly sampled 244 households from a geocoded emergency medical system database. We used a complex survey design and global positioning system units to locate houses and randomly selected one eligible household member to administer a questionnaire and a 13C-urea breath test for active H. pylori infection (n = 166). In weighted analyses, active H. pylori infection was detected in 55·0% of the sample. Factors associated with infection on multivariate analysis included using a public drinking-water supply [odds ratio (OR) 12·2, 95% confidence interval (CI) 2·9-50·7] and current cigarette smoking (OR 4·1, 95% CI 1·7-9·6). People who lived in houses with more rooms, a possible indicator of decreased crowding in the home, were less likely to have active H. pylori infections (OR 0·7, 95% CI 0·5-0·9 for each additional room).
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Kim YS, Baik GH. Epidemiology ofHelicobacter pyloriInfection in Korea. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2011. [DOI: 10.7704/kjhugr.2011.11.1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Yeon Soo Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
| | - Gwang Ho Baik
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea
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Helicobacter pylori infection and Hyperemesis gravidarum. An institution-based case–control study. Eur J Epidemiol 2008; 23:491-8. [PMID: 18493859 DOI: 10.1007/s10654-008-9261-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Accepted: 04/23/2008] [Indexed: 01/01/2023]
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Bures J, Kopácová M, Koupil I, Vorísek V, Rejchrt S, Beránek M, Seifert B, Pozler O, Zivný P, Douda T, Kolesárová M, Pintér M, Palicka V, Holcík J. Epidemiology of Helicobacter pylori infection in the Czech Republic. Helicobacter 2006; 11:56-65. [PMID: 16423091 DOI: 10.1111/j.0083-8703.2006.00369.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Prevalence of Helicobacter pylori infection has been estimated to range from 60 to 95% in the former communist countries of Central and Eastern Europe. The aim of this study was to evaluate H. pylori infection prevalence in a representative sample of the Czech population. The second objective was to describe difference of H. pylori prevalence between different social groups of children and adults. MATERIALS AND METHODS A total of 2509 persons aged 5-100 years, randomly selected out of 30,012 persons of the general population, took part in the study. H. pylori infection was investigated by means of 13C-urea breath test. Breath samples were analyzed by isotope ratio mass spectrometry. Social and demographic characteristics were based on data from self-completed questionnaires. RESULTS Using the total Czech population as a standard, we estimated the age-standardized prevalence of H. pylori in males aged 5+ years at 41.9% (95% CI 39.0%, 44.8%) and in females aged 5+ years at 41.4% (95% CI 38.6%, 44.3%) in 2001. Prevalence of H. pylori increased with age but was not related to gender. Children of mothers with basic or lower education, living in crowded accommodations, without access to running warm water, and residing in smaller towns appear to be at the highest risk. Low education and heavy smoking are most strongly associated with prevalence of H. pylori positivity in adults and adolescents. CONCLUSIONS This is a unique study based on a representative sample of the general population in a Central European country. The overall prevalence of H. pylori is lower than previously assumed and could partly reflect a substantial recent decrease in H. pylori prevalence in the Czech Republic. Consistent with earlier studies, H. pylori infection is strongly influenced by socioeconomic conditions and childhood poverty.
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Affiliation(s)
- Jan Bures
- 2nd Department of Medicine, Charles University in Praha, Faculty of Medicine at Hradec Králové, University Teaching Hospital, Hradec Králové, Czech Republic.
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De Francesco V, Zullo A, Hassan C, Della Valle N, Pietrini L, Minenna MF, Winn S, Monno R, Stoppino V, Morini S, Panella C, Ierardi E. The prolongation of triple therapy for Helicobacter pylori does not allow reaching therapeutic outcome of sequential scheme: a prospective, randomised study. Dig Liver Dis 2004; 36:322-326. [PMID: 15191200 DOI: 10.1016/j.dld.2003.12.015] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM One-week triple therapy for Helicobacter pylori revealed, during these last few years, a decrease in the eradication rate, so that the prolongation of its duration has been proposed. A sequential scheme recently showed very satisfactory results. We performed a prospective randomised study with the aim of either evaluating whether the triple therapy prolongation may improve its effectiveness and comparing its outcome with that of sequential regimen. PATIENTS AND METHODS Three hundred and forty-two H. pylori positive patients completed the study. They were randomised to receive one of the following treatments: (i) a 7-day triple therapy comprising of rabeprazole (20 mg, b.i.d.) plus clarithromycin (500 mg, b.i.d.) and amoxycillin (1 g, b.i.d.); (ii) a 10-day triple therapy comprising the same scheme; (iii) a 10-day sequential regimen comprising of rabeprazole (20 mg, b.i.d.) plus amoxycillin (1 g, b.i.d.) for 5 days followed by rabeprazole (20 mg, b.i.d.) plus clarithromycin (500 mg, b.i.d.) and tinidazole (500 mg, b.i.d.) for the next 5 days. Therapeutic results were expressed using both intention-to-treat and per protocol analyses with 95% confidence intervals. A model of multivariate logistic regression analysis was performed using therapeutic outcome as a dependent variable and including endoscopic finding, smoking habit, age and sex as candidates for the model. RESULTS Sequential regimen showed a significant gain in the eradication rate as compared to the 7-day (P < 0.0001) and the 10-day (P < 0.01) triple therapies, respectively. Overall eradication was lower in smokers than in non-smokers, but the difference remained significant only in the 7-day triple therapy (P < 0.01). Additionally, the overall eradication was higher in peptic ulcer than dyspepsia (P < 0.01), even if this difference was significant only for both triple therapies. CONCLUSIONS Seven-day triple therapy achieves disappointing eradication rates in dyspeptics and smokers. Prolonging triple therapy to 10 days does not significantly improve the eradication rate. The novel 10-day sequential regimen is more effective and equally tolerated than the 10-day triple therapy.
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Affiliation(s)
- V De Francesco
- Gastroenterology Unit, University of Foggia, Riuniti Hospital, Viale L. Pinto, 71100 Foggia, Italy
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Brown LM, Thomas TL, Ma JL, Chang YS, You WC, Liu WD, Zhang L, Pee D, Gail MH. Helicobacter pylori infection in rural China: demographic, lifestyle and environmental factors. Int J Epidemiol 2002; 31:638-45. [PMID: 12055167 DOI: 10.1093/ije/31.3.638] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although Helicobacter pylori is one of the most common human bacterial infections worldwide, its mode of transmission is unclear. METHODS To investigate possible associations between H. pylori infection and demographic, lifestyle, and environmental factors in a rural Chinese population, a cross-sectional survey was administered to 3288 adults (1994 seropositive, 1019 seronegative, 275 indeterminate) from 13 villages in Linqu County, Shandong Province, China. RESULTS Helicobacter pylori prevalence was elevated for: infrequent handwashing before meals (OR = 1.7, 95% CI: 1.0-3.0), crowding (i.e. sharing a bed with >2 people [OR = 2.3, 95% CI: 1.3-4.2]), washing/bathing in a pond or ditch (OR = 1.5, 95% CI: 1.0-2.4), and medium (OR = 1.6, 95% CI: 1.3-2.0) and low (OR = 2.3, 95% CI: 1.9-2.9) compared to high village education level, and reduced for never being married or divorced (OR = 0.4, 95% CI: 0.2-1.0). There was also a suggestion that source of drinking water, especially water from a shallow village well might be related to H. pylori seropositivity. There was no evidence of an association between H. pylori prevalence and alcohol or tobacco use, raw fruit and vegetable intake, or individual social class measures. CONCLUSIONS The results of this study suggest that person-to-person transmission is the most plausible route of H. pylori infection in this rural Chinese population, but waterborne exposures deserve further investigation.
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Affiliation(s)
- Linda Morris Brown
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Moayyedi P, Axon ATR, Feltbower R, Duffett S, Crocombe W, Braunholtz D, Richards IDG, Dowell AC, Forman D. Relation of adult lifestyle and socioeconomic factors to the prevalence of Helicobacter pylori infection. Int J Epidemiol 2002; 31:624-31. [PMID: 12055165 DOI: 10.1093/ije/31.3.624] [Citation(s) in RCA: 106] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION The influence of adult socioeconomic status, co-habitation, gender, smoking, coffee and alcohol intake on risk of Helicobacter pylori infection is uncertain. METHODS Subjects between aged 40-49 years were randomly invited to attend their local primary care centre. Participants were interviewed by a researcher on smoking, coffee and alcohol intake, history of living with a partner, present and childhood socioeconomic conditions. Helicobacter pylori status was determined by 13C-urea breath test. RESULTS In all, 32 929 subjects were invited, 8429 (26%) were eligible and 2327 (27.6%) were H. pylori positive. Helicobacter pylori infection was more common in men and this association remained after controlling for childhood and adult risk factors in a logistic regression model (odds ratio [OR] = 1.15; 95% CI: 1.03-1.29). Living with a partner was also an independent risk factor for infection (OR = 1.30; 95% CI: 1.01-1.67), particularly in partners of lower social class (social class IV and V-OR = 1.47; 95% CI: 1.19-1.81, compared with social class I and II). Helicobacter pylori infection was more common in lower social class groups (I and II-22% infected, III-29% infected, IV and V-38% infected) and there was a significant increase in risk of infection in manual workers compared with non-manual workers after controlling for other risk factors (OR = 1.18; 95% CI: 1.03-1.34). Alcohol and coffee intake were not independent risk factors for infection and smoking was only a risk factor in those smoking >35 cigarettes a day. CONCLUSIONS Male gender, living with a partner and poor adult socioeconomic conditions are associated with increased risk of H. pylori infection.
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Affiliation(s)
- Paul Moayyedi
- Centre for Digestive Diseases, The General Infirmary at Leeds, UK.
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Jarosz M, Dzieniszewski J, Dabrowska-Ufniarz E, Wartanowicz M, Ziemlanski S. Tobacco smoking and vitamin C concentration in gastric juice in healthy subjects and patients with Helicobacter pylori infection. Eur J Cancer Prev 2000; 9:423-8. [PMID: 11201681 DOI: 10.1097/00008469-200012000-00008] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Low gastric juice total vitamin C concentration in the presence of Helicobacter pylori infection probably plays a role in gastric carcinogenesis. Vitamin C plays a role in the neutralization of various pathogenic factors connected with H. pylori infection, including the destruction of free radicals, which damage tissues and cell DNA, and inhibition of the formation of N-nitroso compounds, which have a strong carcinogenic activity. The aim of the study was to determine whether tobacco smoking had any effect on gastric juice vitamin C concentration in healthy subjects and in patients infected with H. pylori. Eighty-six patients with dyspeptic symptoms undergoing routine endoscopy entered the study after giving informed consent. In all patients plasma and gastric juice total vitamin C levels were measured by a spectrophotometric method. They were entered into four groups: group I (controls) - H. pylori-negative non-smokers (n = 17), group II - H. pylori-negative smokers (n = 16), group III - non-smokers with H. pylori infection (n = 21), and group IV - H. pylori-infected smokers (n = 32). In the control group (I) the mean gastric juice total vitamin C concentration was 17.1 microg/ml (range 5.3-40.0 microg/ml), which was significantly higher (P < 0.05) than in group II (12.6 microg/ml, range 5.1-21.0 microg/ml), group III (5.8 microg/ml range 2.1-13.7 microg/ml) and group IV (3.9 microg/ml, range 1.1-10.6 microg/ml) (P < 0.001). Statistically significant differences also were noted between groups II and III (P < 0.01) and groups II and IV (P < 0.001) and between groups III and IV (P < 0.05). These results demonstrate that the concentration of vitamin C in gastric juice is significantly lower in smokers than in non-smokers. This was observed in healthy subjects as well as H. pylori-infected patients. This phenomenon may be one of the mechanisms whereby smoking contributes to the production of gastric lesions, impairs healing of peptic ulcers and also increases the recurrence rate of peptic ulcers in cases with H. pylori infection.
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Affiliation(s)
- M Jarosz
- Department of Metabolic Diseases and Gastroenterology, National Food and Nutrition Institute, Warsaw, Poland
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Ràfols Crestani A, Solanas Saura P, Ramió Pujolràs G, Suelves Esteban N, Rodríguez González C, González Pastor C, Pallarès Segarra M. [Prevalence of Helicobacter pylori infection in primary health care]. Aten Primaria 2000; 25:563-7. [PMID: 10876951 PMCID: PMC7683968 DOI: 10.1016/s0212-6567(00)78569-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/1999] [Accepted: 11/15/1999] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES To find the prevalence of Helicobacter pylori (Hp) infection in the population as a whole. To assess its relationship with the associated factors described in other studies. DESIGN Transversal study of an urban population of 20,000. PARTICIPANTS Between 14 and 80 years old. Randomised sampling of the computerised records (640 clinical histories). Necessary sample n = 384 (alpha = 0.05, prior prevalence = 50%, precision 0.05). MEASUREMENTS Breath test with urea marked (13C), age, sex, alcohol and tobacco consumption, social class and dyspepsia and/or gastro-duodenal pathology. RESULTS 123 exclusions. 122 losses (23%). 397 people screened, 43.6% male. Average age: 42.6. 41.6% consumed alcohol. 30.5% smoked. Prevalence of dyspepsia, gastritis, gastric ulcer and duodenal ulcer, 14%, 2.8%, 2.8% and 2.0%, respectively. Hp prevalence: 56.1% (95% CI, 51.2-60.1). There were no significant differences between prevalence of Hp+ and sex, dyspepsia, peptic ulcer history, gastritis, alcohol consumption and tobacco consumption. Greatest prevalence of Hp+ in over-70s (73%). Significant linear tendency between presence of Hp+ and age (p < 0.05) and low social class (p < 0.05). The logistic regression analysis found a statistically significant relationship only between the presence of H. pylori and age and social class. CONCLUSIONS Prevalence was similar to that in other studies. The relationship between low social class and age and greater Hp prevalence was confirmed. Dyspepsia is not a justification for empirical treatment of Hp. Patients with and without the infection must be followed to evaluate morbidity longitudinally.
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Affiliation(s)
- A. Ràfols Crestani
- Médico de Familia. CAP Maluquer Salvador (Girona). Unidad Docente de Medicina de Familia y Comunitaria de Girona
| | - P. Solanas Saura
- Técnico de Salud. CAP Maluquer Salvador (Girona). Unidad Docente de Medicina de Familia y Comunitaria de Girona
| | - G. Ramió Pujolràs
- Residentes de tercer año de Medicina de Familia y Comunitaria. CAP Maluquer Salvador (Girona). Unidad Docente de Medicina de Familia y Comunitaria de Girona
| | - N. Suelves Esteban
- Residentes de tercer año de Medicina de Familia y Comunitaria. CAP Maluquer Salvador (Girona). Unidad Docente de Medicina de Familia y Comunitaria de Girona
| | - C. Rodríguez González
- Médico de Familia. CAP Maluquer Salvador (Girona). Unidad Docente de Medicina de Familia y Comunitaria de Girona
| | - C. González Pastor
- Médico de Familia. CAP Maluquer Salvador (Girona). Unidad Docente de Medicina de Familia y Comunitaria de Girona
| | - M. Pallarès Segarra
- Médico de Familia. CAP Maluquer Salvador (Girona). Unidad Docente de Medicina de Familia y Comunitaria de Girona
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Murray LJ, Bamford KB, Kee F, McMaster D, Cambien F, Dallongeville J, Evans A. Infection with virulent strains of Helicobacter pylori is not associated with ischaemic heart disease: evidence from a population-based case-control study of myocardial infarction. Atherosclerosis 2000; 149:379-85. [PMID: 10729388 DOI: 10.1016/s0021-9150(99)00325-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Although the majority of evidence does not support association between Helicobacter pylori infection and ischaemic heart disease, the nature of this relationship may differ when virulence of the infecting strains are examined. METHODS AND RESULTS The prevalence of IgG antibody evidence of infection with CagA positive stains of H. pylori was investigated in stored plasma samples from 259 cases of myocardial infarction (aged 25-70 years, 74 males) and 259 population based controls from the same area in Northern Ireland. Two-hundred and seventy (52.1%) subjects were seropositive for anti-CagA IgG. CagA seropositivity was more common in cases than in controls: 56.4 vs 47.9%, odds ratio for seropositivity in cases (95% CI) 1.41 (1.00, 1.99). Substantial attenuation of this relationship occurred on adjustment for age, sex, number of siblings, smoking and measures of socio-economic status: odds ratio (95% CI) 1.16 (0.79, 1.70). A similar pattern was seen for seropositivity for all H. pylori strains. CONCLUSION Infection with the more virulent strains of H. pylori, as with all strains, is not associated with myocardial infarction.
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Affiliation(s)
- L J Murray
- Department of Epidemiology and Public Health, The Queen's University of Belfast, Mulhouse Building, Grosvenor Road, Belfast, UK.
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Sihvo S, Hemminki E. Self medication and health habits in the management of upper gastrointestinal symptoms. PATIENT EDUCATION AND COUNSELING 1999; 37:55-63. [PMID: 10640120 DOI: 10.1016/s0738-3991(98)00103-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Upper gastrointestinal symptoms are a common complaint among the general population but only a small proportion of sufferers seek medical advice. The aim of this study was to examine what kind of perceptions persons using self medication have about the causes of their gastrointestinal symptoms, whether they have made any health-related lifestyle changes, and whether visits to a physician are related to lifestyle changes. A pharmacy-based survey was done in 10 pharmacies in the Helsinki area in 1995. The questionnaire was completed by 292 customers. The response rate was 53%. Respondents in a population-based health interview survey (n = 10,410) were used as a comparison group for poor health-behavior (consumption of tobacco, alcohol, coffee). The most common perceived causes of gastrointestinal symptoms were poor diet, coffee, and stress. Ignorance about possible causes of symptoms was especially common among less educated respondents and among those persons who had never visited a physician due to their symptoms. Respondents were significantly more often smokers and they had attempted to reduce their coffee and alcohol consumption more often than the general population. Those who had visited a physician during past year, less often had poor health-behavior and they had better knowledge about the possible causes of their symptoms. They had also made lifestyle changes more often, but after adjustment for background characteristics, physician visits were positively correlated only with coffee reduction. Counseling about healthy lifestyles, especially about smoking, should be increased in physician consultations and in pharmacies for all patients and customers having gastrointestinal problems.
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Affiliation(s)
- S Sihvo
- Stakes (National Research and Development Centre for Welfare and Health), Helsinki, Finland.
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Fallone CA, Barkun AN, Göttke MU, Beech RN. A review of the possible bacterial determinants of clinical outcome inHelicobacter pyloriinfection. Can J Microbiol 1998. [DOI: 10.1139/w97-143] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Helicobacter pylori is present in 40-60% of the population and approximately 10-20% of these infected individuals suffer from a H. pylori associated disease such as peptic ulcer disease or gastric cancer. This article reviews the potential bacterial determinants responsible for and markers predictive of both the acquisition of H. pylori infection and subsequent clinical outcome; i.e., asymptomatic infection or disease. The acquisition of H. pylori infection depends on exposure (hence the increased risk in lower socioeconomic groups and developing nations) to viable bacteria with at least a functional urease gene in a susceptible host. Once infection occurs, bacterial virulence factors, including the vacuolating cytotoxin, and genes of the cag pathogenicity island, as well as nonbacterial factors may determine disease outcome. Future research is being directed at discovering other bacterial virulence factors responsible for the different clinical outcomes of H. pylori infection. This will be greatly enhanced by the recent release of the complete genome sequence of H. pylori. The determination of the relative importance of each of these recognized and other as yet unrecognized factors responsible for disease outcome will assist in the appropriate targeting of patients in the treatment of H. pylori infection.Key words: Helicobacter pylori, genetics, virulence, bacterial.
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Abstract
The pathogenesis of peptic ulcer disease is multifactorial, including the effects of Helicobacter pylori, gastric acid, pepsin, gastroduodenal motility, smoking and nicotine, and the complex interaction of an array of other so-called aggressive and protective factors. Since the discovery and acceptance of H. pylori as a major etiologic agent in peptic ulcer disease, the role of smoking has received less attention. Smokers are more likely to develop ulcers, ulcers in smokers are more difficult to heal, and ulcer relapse is more likely in smokers. These clinical observations may be explained by the adverse effects that smoking has on mucosal aggressive and protective factors. Of the aggressive factors, smoking appears to have no consistent effect on acid secretion. However, smoking impairs the therapeutic effects of histamine-2 antagonists, may stimulate pepsin secretion, promotes reflux of duodenal contents into the stomach, increases the risk for and harmful effects of H. pylori, and increases production of free radicals, vasopressin, secretion by the pituitary, secretion of endothelin by the gastric mucosa, and production of platelet activating factor. Smoking also affects the mucosal protective mechanisms. It decreases gastric mucosal blood flow and inhibits gastric mucous secretion, gastric prostaglandin generation, salivary epidermal growth factor secretion, duodenal mucosal bicarbonate secretion, and pancreatic bicarbonate secretion. These adverse effects of smoking on aggressive and protective factors quality it as an important contributor to the pathogenesis of peptic ulcer disease and indicate that smoking plays a significant facilitative role in the development and maintenance of peptic ulcer disease.
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Affiliation(s)
- G L Eastwood
- State University of New York Health Science Center, Syracuse 13210-2399, USA
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Halter F, Brignoli R. Helicobacter pylori and smoking: two additive risk factors for organic dyspepsia. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 1998; 71:91-9. [PMID: 10378354 PMCID: PMC2578888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
The hopes to distinguish between organic and functional dyspepsia on the grounds of the patient's symptomatology have not been fulfilled due to the low specificity of the so-called sinister symptoms. There is increasing evidence accumulating that Helicobacter pylori status and other environmental factors such as smoking have a higher discriminant power. Studies performed in our laboratories testing H. pylori status on gastric biopsy samples have shown that preselection of patients according to smoking habits and H. pylori status has a higher potential in avoiding unnecessary endoscopies in primary care patients as compared to risk factors based on patient complaints. Out of a total population of 282 primary care patients, one out of 24 endoscopies revealed significant pathology such as peptic ulcer or reflux esophagitis in the non-smokers with a negative H. pylori status, but when both risk factors were positive, the percentage rose to one out of every two patients. These observation have largely been confirmed by recent studies where H. pylori status was prospectively assessed prior to endoscopy by highly specific H. pylori serology or 13C breath test analysis.
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Affiliation(s)
- F Halter
- Department of Medicine, Inselspital, University of Bern, Switzerland
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Peach HG, Pearce DC, Farish SJ. Helicobacter pylori infection in an Australian regional city: prevalence and risk factors. Med J Aust 1997; 167:310-3. [PMID: 9322776 DOI: 10.5694/j.1326-5377.1997.tb125076.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the prevalence of Helicobacter pylori infection and potential risk factors for infection in an adult Australian population. DESIGN Cross-sectional study. SETTING Ballarat, a major regional city in Victoria (population, 78,000; 92% bom in Australia), November 1994 to July 1995. PARTICIPANTS 217 adults randomly selected from the electoral roll. MAIN OUTCOME MEASURES H. pylori IgG antibody status by enzyme immunoassay; amount of dental plaque; sociodemographic and other potential risk factors; odds ratios for risk factors determined by logistic regression analysis. RESULTS Age-standardised prevalence of H. pylori infection was 30.6%. After adjustment for age, sex and socioeconomic index, positive H. pylori status was significantly associated with increasing number of tooth surfaces with a high plaque score (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7), increasing number of years in a job with public contact (OR, 1.7; 95% CI, 1.3-2.3), blood group B antigen (OR, 3.1; 95% CI, 1.1-9.1), and having lived in a household with more than six members during childhood (OR, 2.5; 95% CI, 1.1-5.5). Negative H. pylori status was significantly associated with increasing education, having ever lived on a farm, and having teeth scaled less than once a year. CONCLUSIONS H. pylori infection is common. Dental plaque may be a reservoir for H. pylori, which is probably transmitted by person-to-person contact, and blood group B antigen may predispose to infection. Community education about effective oral hygiene and adoption of good hygiene practices by those with regular public contact may be important to prevent acquisition and transmission of H. pylori.
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Affiliation(s)
- H G Peach
- Department of Public Health and Community Medicine, University of Melbourne, Ballarat Health Services Base Hospital, VIC.
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Shinchi K, Ishii H, Imanishi K, Kono S. Relationship of cigarette smoking, alcohol use, and dietary habits with Helicobacter pylori infection in Japanese men. Scand J Gastroenterol 1997; 32:651-5. [PMID: 9246703 DOI: 10.3109/00365529708996513] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Little is known of factors determining infection with Helicobacter pylori. METHODS In a cross-sectional study of 566 men aged 50-55 years, who received a preretirement health examination at the Self Defense Forces Fukuoka Hospital between January 1993 and December 1994, we examined the association of smoking, alcohol use, and dietary habits with H. pylori infection. RESULTS The overall seropositivity as determined with IgG antibody was 79.3% (449 of 566). The rank was inversely associated with the infection (trend, P = 0.048). Neither smoking nor alcohol drinking was related to the infection. The prevalence adjusted for rank tended to be lower in men consuming raw vegetables (trend, P = 0.12) daily than those with less consumption. Unexpectedly, the consumption of tofu (soybean curd) was significantly, negatively related to the infection (trend, P = 0.013). The seropositivity was unrelated to the consumption of pickled vegetables, soy paste soup, green tea, or garlic. CONCLUSION The findings suggest that fresh vegetables may be protective against H. pylori infection. The study does not support either an increased risk of the infection associated with salty foods or a protective effect of green tea or garlic.
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Affiliation(s)
- K Shinchi
- Dept. of Public Health, Kyushu University School of Medicine, Fukuoka, Japan
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Bardhan KD, Graham DY, Hunt RH, O'Morain CA. Effects of smoking on cure of Helicobacter pylori infection and duodenal ulcer recurrence in patients treated with clarithromycin and omeprazole. Helicobacter 1997; 2:27-31. [PMID: 9432318 DOI: 10.1111/j.1523-5378.1997.tb00053.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Smoking may affect adversely the cure rate for Helicobacter pylori infection in patients treated with amoxicillin and omeprazole. Therapy with clarithromycin and omeprazole was tested for its effectiveness in the treatment of H. pylori infection in smokers and nonsmokers. MATERIALS AND METHODS Patients with verified duodenal ulcer and H. pylori infection received clarithromycin 500 mg tid, in combination with omeprazole 40 mg/ day, for 2 weeks, followed by omeprazole (20 or 40 mg daily) for 2 additional weeks according to a randomized, double-blind, multicenter design. Patients were analyzed by their smoking status for the cure of H. pylori infection, ulcer healing, and prevention of duodenal ulcer recurrence. RESULTS After treatment with clarithromycin and omeprazole, H. pylori infection was cured in 71% of the smokers and in 77% of the nonsmokers (evaluated 4-6 weeks after treatment). Overall ulcer healing was 95%, and overall ulcer recurrence was 19%. For H. pylori-negative patients, ulcer recurrence was 12% in both smokers and nonsmokers. None of these values was significantly different when smokers were compared to nonsmokers. CONCLUSIONS Therapy with clarithromycin and omeprazole is effective for cure of H. pylori infection in smokers and nonsmokers. Smoking has no effect on duodenal ulcer healing or duodenal ulcer recurrence for patients treated with this regimen.
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Imhof M, Ohmann C, Hartwig A, Thon KP, Hengels KJ, Röher HD. Which peptic ulcers bleed? Results of a case-control study. DUSUK Study Group. Scand J Gastroenterol 1997; 32:131-8. [PMID: 9051873 DOI: 10.3109/00365529709000183] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND The incidence of ulcer bleeding has not decrease despite effective medical treatment of peptic ulcer disease. Numerous studies have been performed on risk factors for ulcer bleeding, but only a few studies have related the risk of developing ulcer bleeding to the risk of developing uncomplicated ulcer disease. METHODS This study was performed as a multicenter interdisciplinary case-control study and was based on diagnosis by endoscopy, prospective data collection, and multivariate analysis. To every study patient with ulcer bleeding (case) one patient with uncomplicated peptic ulcer proven at endoscopy (control) was assigned with regard to sex, ulcer localization, and age (+/-5 years). The controls were randomly taken from three sources: inpatients, outpatients, and patients treated by a private physician. RESULTS Owing to strict inclusion and exclusion criteria, 209 matched pairs were available for evaluation out of 401 patients with peptic ulcer bleeding. In univariate analysis the duration of ulcer pain and the number of previous ulcer treatments proved to be protective factors for ulcer bleeding. The intake of non-steroidal anti-inflammatory drugs (NSAID) as a whole, acetylsalicylic acid (aspirin), and paracetamol gave an increased risk for ulcer bleeding. Multivariate analysis identified four risk factors for peptic ulcer bleeding: lung disease, NSAID intake, no pretreatment with H2 blockers, and acetylsalicylic acid intake. CONCLUSIONS The following patient groups represent a risk for peptic ulcer bleeding: multimorbid patients, receiving NSAID and/or aspirin, and patients with no previous ulcer history.
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Affiliation(s)
- M Imhof
- Dept. of General and Trauma Surgery, Heinrich-Heine University, Düsseldorf, Germany
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Affiliation(s)
- C S Goodwin
- Division of Gastroenterology, Endocrinology and Metabolism, St George's Hospital Medical School, London, UK
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Zambon JJ, Grossi SG, Machtei EE, Ho AW, Dunford R, Genco RJ. Cigarette smoking increases the risk for subgingival infection with periodontal pathogens. J Periodontol 1996; 67:1050-4. [PMID: 8910822 DOI: 10.1902/jop.1996.67.10s.1050] [Citation(s) in RCA: 199] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Cigarette smoking has been found to increase the risk for periodontitis. The present study examined the association between cigarette smoking and subgingival infection with periodontal pathogens to determine if smokers are more likely to be infected with certain periodontal pathogens than non-smokers. Self-reported data on 1,426 subjects, aged 25 to 74, from the Erie County Study were obtained including data on 798 subjects who were current or former smokers. Mean clinical attachment loss was used to estimate the severity of periodontal destruction. Subgingival infection with target periodontal pathogens was determined by indirect immunofluorescence microscopy. Smokers harbored significantly higher levels and were at significantly greater risk of infection with Bacteroides forsythus than non-smokers. Adjusting for disease severity, the risk of subgingival infection with B. forsythus in current smokers was 2.3 times that of former smokers or non-smokers. The relative risk of B. forsythus infection also increased 1.18 times for every category of smoking as the amount of smoking measured in packyears increased from very light to heavy. Adjusting for disease severity, Porphyromonas gingivalis was also more likely to subgingivally infect smokers than non-smokers; however, there was not a significantly higher relative risk for infection with this bacterium. The data from this study indicate that cigarette smoking increases the likelihood of subgingival infection with certain periodontal pathogens. This may partly explain the increased risk for periodontitis seen in smokers.
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Affiliation(s)
- J J Zambon
- Periodontal Disease Research Center, State University of New York, Buffalo, USA
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Abstract
A case-control study was undertaken to determine whether esophagitis in children correlated with exposure to parental cigarette smoking. At least one parent smoked in 77 (79%) of 97 families in the study group, compared with 42 (38.9%) of the 108 families in the control group (p < 0.001). Passive smoking is a risk factor for the development of esophagitis in children, providing added support for public health efforts to restrict childhood exposure to tobacco smoke.
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Affiliation(s)
- S M Shabib
- Division of Gastroenterology, Hospital for Sick Children, Toronto, Ontario, Canada
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Lambert JR, Lin SK, Aranda-Michel J. Helicobacter pylori. SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY. SUPPLEMENT 1995; 208:33-46. [PMID: 7777803 DOI: 10.3109/00365529509107760] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Helicobacter pylori is an important cause of chronic active gastritis and is strongly associated with peptic ulcer disease and gastric cancer. H. pylori colonizes the surface of the gastric epithelium with production of a number of factors, resulting in inflammation and an altered mucosa. H. pylori infection occurs world-wide and the mode of transmission most likely is from human to human via the fecal-oral and/or the oral-oral route. Treatment and, in the future, prevention of this infection may result in a marked diminution of upper gastrointestinal tract disease.
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Affiliation(s)
- J R Lambert
- Gastroenterology Research Group, Mornington Peninsula Hospital, Frankston, Victoria, Australia
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Endoh K, Leung FW. Effects of smoking and nicotine on the gastric mucosa: a review of clinical and experimental evidence. Gastroenterology 1994; 107:864-78. [PMID: 7915701 DOI: 10.1016/0016-5085(94)90138-4] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Epidemiological and experimental evidence have shown that nicotine has harmful effects on the gastric mucosa. The mechanisms by which cigarette smoking or nicotine adversely affect the gastric mucosa have not been fully elucidated. In this report, clinical and experimental data are reviewed. The effects of nicotine from smoking on gastric aggressive or defensive factors are discussed. Nicotine potentiates gastric aggressive factors and attenuates defensive factors; it also increases acid and pepsin secretions, gastric motility, duodenogastric reflux of bile salts, the risk of Helicobacter pylori infection, levels of free radicals, and platelet-activating factor, endothelin generation, and vasopressin secretion. Additionally, nicotine impairs the therapeutic effect of H2-receptor antagonists and decreases prostaglandin synthesis, gastric mucosal blood flow, mucus secretion, and epidermal growth factor secretion. Although many of the studies provide conflicting results, the bulk of the evidence supports the hypothesis that nicotine is harmful to the gastric mucosa.
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Affiliation(s)
- K Endoh
- First Department of Internal Medicine, Nagoya City University Medical School, Japan
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Bateson MC. Gastroenterology--I: Gastroduodenal disease and Helicobacter pylori. Postgrad Med J 1994; 70:561-7. [PMID: 7937449 PMCID: PMC2397689 DOI: 10.1136/pgmj.70.826.561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- M C Bateson
- General Hospital, Bishop Auckland, Co. Durham, UK
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35
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Yokoyama Y, Kino J, Okazaki K, Yamamoto Y. Mycobacteria in the human intestine. Gut 1994; 35:715-6. [PMID: 8200578 PMCID: PMC1374772 DOI: 10.1136/gut.35.5.715-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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37
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Bateson MC. Helicobacter pylori eradication. Lancet 1994; 343:855. [PMID: 7908097 DOI: 10.1016/s0140-6736(94)92056-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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