# Helicobacter pylori infection and IBS



## eric (Jul 8, 1999)

Okay, I need some help on figuring out these.The association between Helicobacter pylori infection and functional dyspepsia in patients with irritable bowel syndrome. Su YC, Wang WM, Wang SY, Lu SN, Chen LT, Wu DC, Chen CY, Jan CM, Horowitz M Department of Internal Medicine, Kaohsiung Medical University Hospital, Taiwan. [Medline record in process] OBJECTIVE: Irritable bowel syndrome (IBS) is associated with an exaggerated response to a variety of physiological and nonphysiological gastrointestinal stimuli. Many patients with IBS also have functional dyspepsia. Our aim was to examine the hypothesis that Helicobacter pylori (H. pylori) infection may predispose IBS patients to functional dyspepsia. METHODS: In 69 IBS patients, dyspeptic symptoms, H. pylori status, and sociodemographic and psychological variables (perceived stress, trait anxiety, and depression) were assessed. Sociodemographic and psychological variables were also evaluated in 52 control subjects. RESULTS: Mean scores for perceived stress (17.1 +/- 6.0 vs 14.9 +/- 6.0, p = 0.05), trait anxiety (45.6 +/- 9.1 vs 41.1 +/- 7.8, p = 0.004) and depression (9.9 +/- 8.4 vs 5.0 +/- 5.5, p = 0.0002) were higher in IBS patients than in controls. In all, 33 of the 69 patients (47.8%) had H. pylori infection, and this was associated with relevant symptoms of epigastric pain (odds ratio [OR] = 6.77, 95% confidence interval [CI] 1.89-24.3) and postprandial upper abdominal fullness (OR = 4.23, 95% CI 1.38-13.2). H. pylori infection and female gender were independent predictors of the presence of relevant dyspepsia (OR = 8.31, 95% CI 2.35-29.5 and 6.06, 95% CI 1.71-21.5, respectively). Symptom intensity was associated with the level of perceived stress (total relevant symptom number > or =3 vs <3, OR = 1.16 per point on a 40-point perceived stress scale, 95% CI 1.01-1.34). CONCLUSIONS: In IBS patients, the presence of dyspepsia is associated with H. pylori infection, female gender, and perceived stress.Helicobacter pylori and dyspepsia: a population-based study of the organism and host. Locke CR 3rd, Talley NJ, Nelson DK, Haruma K, Weaver AL, Zinsmeister AR, Melton LJ 3rd Department of Health Sciences Research, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. [Medline record in process] OBJECTIVE: The role of Helicobacter pylori (HP) infection in dyspepsia in the absence of peptic ulcer remains controversial. Specific attributes of the organism or the host response may be important. We aimed to determine whether HP infection overall, CagA status, serum gastrin, or serum pepsinogen levels are associated with dyspepsia in the community. METHODS: A self-report bowel disease questionnaire was mailed to a random sample of Olmsted County, Minnesota residents, aged 20-50 yr. All respondents who reported symptoms of dyspepsia or irritable bowel syndrome (cases) and all respondents without significant GI symptoms (controls) were invited to participate (n = 260). They were each assessed by a physician and their medical records reviewed. Serum was obtained to measure HP and CagA antibodies, pepsinogen I and II levels, and basal serum gastrin using validated assays. RESULTS: Of the 148 (57%) subjects who agreed to participate, 36 had dyspepsia (17 had ulcer-like dyspepsia), 35 had irritable bowel syndrome (IBS) without dyspepsia, and 77 were asymptomatic. The proportion who were seropositive for HP were 17% in dyspepsia (24% in ulcer-like dyspepsia), 20% in IBS, and 12% in asymptomatic controls. HP was not associated with dyspepsia, ulcer-like dyspepsia, or IBS after adjusting for age. Pepsinogen levels and serum gastrin were not associated with any of the conditions studied. However, CagA antibody positivity was associated with IBS (p < 0.05), and a borderline statistically significant association with dyspepsia was detected (p = 0.08). CONCLUSIONS: In this community, HP infection overall does not seem to explain dyspepsia, although the role of CagA-positive HP strains deserve further study.------------------ http://www.ibshealth.com/


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## JeanG (Oct 20, 1999)

Thanks for posting this, Eric.







It is a complicated one to understand. It's 5:45 am and my brain isn't awake yet.







Even when it's awake, this will be hard.All I could get out of it is that H. pylori could predispose IBS patients to funtional dyspepsia, and in IBS patients "dyspepsia is associated with H. pylori infection, female gender, and perceived stress". I'll read it again when I have more time.Thanks again! Hopefully someone else can come up with an explanation.







JeanG


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## NewForMe (Mar 5, 2000)

Was just tested for this and my results were negative, though they never explained exactly what it was. I was just happy it was negative.


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## JeanG (Oct 20, 1999)

Does anyone have any ideas on these? I'd sure like to know more than the little bit I understand!







JeanG


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## Guest (Aug 25, 2000)

This is very interesting to me. I didn't totally understand it, but I am going to print it out and"study"it. I have IBS and a couple of months ago I went to the doctor with really bad ulcer symptoms I tested positive for the H. Pylori ,after antibiotics the ulcer seemed to clear up and I was feeling much better, now I am getting these mild chest pains and indigestion which from my research sounds like it could be functional dyspesia. So, I am very interested in whether these are all related.If anyone gets any more info or interprets it differently I would love to hear about it.


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## patjack (May 23, 2000)

When I had my scope done they found scar tissue and inflammation of my stomach from an old healed ulcer that now left Pylori bacteria present---have to go on antibiotics---I have acid reflux and the IBS---is this all connected??? Thanks! Trish------------------trish


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## JeanG (Oct 20, 1999)

Hi Pat:I don't know the answer to your question, but I'll bump this up so more people see it and perhaps help!JeanG


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