Low prevalence of Helicobacter pylori in inflammatory bowel disease: association with sulphasalazine

E. El-Omar, I Penman, G. Cruikshank, S. Dover, S Banerjee, C Williams, K.E.L. McColl

Research output: Contribution to journalArticle

Abstract

The prevalence of IgG antibodies to Helicobacter pylori was examined in 110 patients with inflammatory bowel disease (IBD) (63 ulcerative colitis, 47 Crohn's disease) and compared with 100 age and sex matched control patients. The overall prevalence of H pylori seropositivity in the IBD patients was 22%, which was significantly less than that of 52% in the controls (p < 0.002). There was no difference in prevalence between ulcerative colitis and Crohn's patients. The low seropositivity in the IBD patients resulted from a very low prevalence of 10% in those currently receiving sulphasalazine (n = 40) and similarly low prevalence of 7% in those previously receiving sulphasalazine (n = 30). In those receiving olsalazine or mesalazine and who had never had sulphasalazine, the prevalence of seropositivity was 45%. Further studies using 14C urea breath test and microscopy of antral biopsy specimens confirmed that the negative serology in patients receiving sulphasalazine resulted from absence of the infection rather than absence of humoral immune response to it. In six control patients with H pylori infection, a two week course of sulphasalazine (500 mg four times daily) only caused slight suppression of the 14C urea breath test. In vitro studies failed to show any direct antibacterial effect of sulphasalazine on H pylori. These findings indicate that longterm treatment with sulphasalazine leads to eradication of H pylori infection and that this does not result from a direct antibacterial effect. It may be caused by the drug treating the gastritis and thereby depriving the bacterium of essential nutrients exuded by the inflamed mucosa.

Original languageEnglish
Pages (from-to)1385-1388
Number of pages4
JournalGut
Volume35
Issue number10
DOIs
Publication statusPublished - Oct 1994
Externally publishedYes

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Sulfasalazine
Inflammatory Bowel Diseases
Helicobacter pylori
Pylorus
Breath Tests
Ulcerative Colitis
Urea
Infection
Mesalamine
Gastritis
Serology
Humoral Immunity
Crohn Disease
Microscopy
Mucous Membrane
Immunoglobulin G
Bacteria
Biopsy
Food
Antibodies

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Bacterial
  • Breath Tests
  • Colitis, Ulcerative
  • Crohn Disease
  • Female
  • Helicobacter pylori
  • Humans
  • Immunoglobulin G
  • Male
  • Middle Aged
  • Prevalence
  • Sulfasalazine
  • Comparative Study
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

El-Omar, E., Penman, I., Cruikshank, G., Dover, S., Banerjee, S., Williams, C., & McColl, K. E. L. (1994). Low prevalence of Helicobacter pylori in inflammatory bowel disease: association with sulphasalazine. Gut, 35(10), 1385-1388. https://doi.org/10.1136/gut.35.10.1385
El-Omar, E. ; Penman, I ; Cruikshank, G. ; Dover, S. ; Banerjee, S ; Williams, C ; McColl, K.E.L. / Low prevalence of Helicobacter pylori in inflammatory bowel disease : association with sulphasalazine. In: Gut. 1994 ; Vol. 35, No. 10. pp. 1385-1388.
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abstract = "The prevalence of IgG antibodies to Helicobacter pylori was examined in 110 patients with inflammatory bowel disease (IBD) (63 ulcerative colitis, 47 Crohn's disease) and compared with 100 age and sex matched control patients. The overall prevalence of H pylori seropositivity in the IBD patients was 22{\%}, which was significantly less than that of 52{\%} in the controls (p < 0.002). There was no difference in prevalence between ulcerative colitis and Crohn's patients. The low seropositivity in the IBD patients resulted from a very low prevalence of 10{\%} in those currently receiving sulphasalazine (n = 40) and similarly low prevalence of 7{\%} in those previously receiving sulphasalazine (n = 30). In those receiving olsalazine or mesalazine and who had never had sulphasalazine, the prevalence of seropositivity was 45{\%}. Further studies using 14C urea breath test and microscopy of antral biopsy specimens confirmed that the negative serology in patients receiving sulphasalazine resulted from absence of the infection rather than absence of humoral immune response to it. In six control patients with H pylori infection, a two week course of sulphasalazine (500 mg four times daily) only caused slight suppression of the 14C urea breath test. In vitro studies failed to show any direct antibacterial effect of sulphasalazine on H pylori. These findings indicate that longterm treatment with sulphasalazine leads to eradication of H pylori infection and that this does not result from a direct antibacterial effect. It may be caused by the drug treating the gastritis and thereby depriving the bacterium of essential nutrients exuded by the inflamed mucosa.",
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El-Omar, E, Penman, I, Cruikshank, G, Dover, S, Banerjee, S, Williams, C & McColl, KEL 1994, 'Low prevalence of Helicobacter pylori in inflammatory bowel disease: association with sulphasalazine' Gut, vol. 35, no. 10, pp. 1385-1388. https://doi.org/10.1136/gut.35.10.1385

Low prevalence of Helicobacter pylori in inflammatory bowel disease : association with sulphasalazine. / El-Omar, E.; Penman, I; Cruikshank, G.; Dover, S.; Banerjee, S; Williams, C; McColl, K.E.L.

In: Gut, Vol. 35, No. 10, 10.1994, p. 1385-1388.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Low prevalence of Helicobacter pylori in inflammatory bowel disease

T2 - association with sulphasalazine

AU - El-Omar, E.

AU - Penman, I

AU - Cruikshank, G.

AU - Dover, S.

AU - Banerjee, S

AU - Williams, C

AU - McColl, K.E.L.

PY - 1994/10

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N2 - The prevalence of IgG antibodies to Helicobacter pylori was examined in 110 patients with inflammatory bowel disease (IBD) (63 ulcerative colitis, 47 Crohn's disease) and compared with 100 age and sex matched control patients. The overall prevalence of H pylori seropositivity in the IBD patients was 22%, which was significantly less than that of 52% in the controls (p < 0.002). There was no difference in prevalence between ulcerative colitis and Crohn's patients. The low seropositivity in the IBD patients resulted from a very low prevalence of 10% in those currently receiving sulphasalazine (n = 40) and similarly low prevalence of 7% in those previously receiving sulphasalazine (n = 30). In those receiving olsalazine or mesalazine and who had never had sulphasalazine, the prevalence of seropositivity was 45%. Further studies using 14C urea breath test and microscopy of antral biopsy specimens confirmed that the negative serology in patients receiving sulphasalazine resulted from absence of the infection rather than absence of humoral immune response to it. In six control patients with H pylori infection, a two week course of sulphasalazine (500 mg four times daily) only caused slight suppression of the 14C urea breath test. In vitro studies failed to show any direct antibacterial effect of sulphasalazine on H pylori. These findings indicate that longterm treatment with sulphasalazine leads to eradication of H pylori infection and that this does not result from a direct antibacterial effect. It may be caused by the drug treating the gastritis and thereby depriving the bacterium of essential nutrients exuded by the inflamed mucosa.

AB - The prevalence of IgG antibodies to Helicobacter pylori was examined in 110 patients with inflammatory bowel disease (IBD) (63 ulcerative colitis, 47 Crohn's disease) and compared with 100 age and sex matched control patients. The overall prevalence of H pylori seropositivity in the IBD patients was 22%, which was significantly less than that of 52% in the controls (p < 0.002). There was no difference in prevalence between ulcerative colitis and Crohn's patients. The low seropositivity in the IBD patients resulted from a very low prevalence of 10% in those currently receiving sulphasalazine (n = 40) and similarly low prevalence of 7% in those previously receiving sulphasalazine (n = 30). In those receiving olsalazine or mesalazine and who had never had sulphasalazine, the prevalence of seropositivity was 45%. Further studies using 14C urea breath test and microscopy of antral biopsy specimens confirmed that the negative serology in patients receiving sulphasalazine resulted from absence of the infection rather than absence of humoral immune response to it. In six control patients with H pylori infection, a two week course of sulphasalazine (500 mg four times daily) only caused slight suppression of the 14C urea breath test. In vitro studies failed to show any direct antibacterial effect of sulphasalazine on H pylori. These findings indicate that longterm treatment with sulphasalazine leads to eradication of H pylori infection and that this does not result from a direct antibacterial effect. It may be caused by the drug treating the gastritis and thereby depriving the bacterium of essential nutrients exuded by the inflamed mucosa.

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KW - Aged

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KW - Antibodies, Bacterial

KW - Breath Tests

KW - Colitis, Ulcerative

KW - Crohn Disease

KW - Female

KW - Helicobacter pylori

KW - Humans

KW - Immunoglobulin G

KW - Male

KW - Middle Aged

KW - Prevalence

KW - Sulfasalazine

KW - Comparative Study

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

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JO - Gut

JF - Gut

SN - 0017-5749

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ER -