Peptic ulcer bleeding: is Helicobacter pylori a risk factor in an endemic area?

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dc.contributor.authorSotoudehmanesh, Rasoulen_US
dc.contributor.authorAsgari, Ali Alien_US
dc.contributor.authorFakheri, Hafez Tirgaren_US
dc.contributor.authorNouraie, Mehdien_US
dc.contributor.authorKhatibian, Mortezaen_US
dc.contributor.authorShirazian, Nahiden_US
dc.date.accessioned2005-03-10en_US
dc.date.accessioned2009-05-29T03:23:56Z
dc.date.available2005-03-10en_US
dc.date.available2009-05-29T03:23:56Z
dc.date.issued2005-03-10en_US
dc.description.abstractBACKGROUND/OBJECTIVE: A high prevalence of Helicobacter pylori infection has been reported in Iran. Although the importance of H. pylori in the induction of peptic ulcer disease is clearly defined, only few studies have addressed its role in bleeding from peptic ulcers. We evaluated the role of H. pylori in peptic ulcer bleeding. METHODS: Patients with acute peptic ulcer bleeding (PUB) and those with peptic ulcer disease without bleeding ('controls') were enrolled. Upper GI endoscopy and rapid urease test were performed in both groups. Histological study for detection of H. pylori was performed in patients with active bleeding, if RUT was negative. Other variables evaluated included sex, age, smoking, previous history of bleeding, non-steroidal anti-inflammatory drugs use, ulcer size, ulcer location, and duration of acid-peptic disease. Multivariate logistic regression analysis was performed to identify independent risk factors. RESULTS: 161 patients with PUB and 287 control patients were enrolled. H. pylori infection was seen more frequently in patients with duodenal ulcer than gastric ulcer (88.9% vs. 60.5%, p< 0.001). Univariate analysis showed that patients with PUB were more often male, older in age, used NSAID, had history of PUB in the past, had ulcer located in the stomach and not in the duodenum, and more often had large ulcer (>1 cm). Logistic regression analysis showed that H. pylori infection was protective in PUB after controlling for confounders (OR 0.41, 95% CI 0.21-0.79), when ulcer location was not entered in the model. A second model including ulcer location (to test for a residual effect) showed that H. pylori infection was not a significant risk factor in PUB (OR 0.61, 95% CI 0.30-1.24). CONCLUSIONS: H. pylori may not be an independent factor in bleeding from peptic ulcers. The lower frequency of this infection in these patients can be described by the higher frequency of bleeding from gastric ulcers, which are less H. pylori related compared with duodenal ulcer.en_US
dc.description.affiliationDigestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran. sotoudehmanesh@ddrcir.orgen_US
dc.identifier.citationSotoudehmanesh R, Asgari AA, Fakheri HT, Nouraie M, Khatibian M, Shirazian N. Peptic ulcer bleeding: is Helicobacter pylori a risk factor in an endemic area? Indian Journal of Gastroenterology. 2005 Mar-Apr; 24(2): 59-61en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/65289
dc.language.isoengen_US
dc.source.urihttps://www.indianjgastro.comen_US
dc.subject.meshAdulten_US
dc.subject.meshEndemic Diseasesen_US
dc.subject.meshFemaleen_US
dc.subject.meshHelicobacter Infections --epidemiologyen_US
dc.subject.meshHelicobacter pylorien_US
dc.subject.meshHumansen_US
dc.subject.meshIran --epidemiologyen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPeptic Ulcer Hemorrhage --epidemiologyen_US
dc.subject.meshRisk Factorsen_US
dc.titlePeptic ulcer bleeding: is Helicobacter pylori a risk factor in an endemic area?en_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
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