Randomized placebo-controlled trial of Helicobacter pylori eradication for iron-deficiency anemia in preadolescent children and adolescents

Helicobacter. 1999 Jun;4(2):135-9. doi: 10.1046/j.1523-5378.1999.98066.x.


Background: A few cases relating H. pylori infection to iron-deficiency anemia have been described recently. We investigated the role of H. pylori infection in iron-deficiency anemia in preadolescent children and adolescents.

Patients and methods: We conducted a double-blind, placebo-controlled therapeutic trial in 43 subjects (mean age, 15.4 years) with iron-deficiency anemia. Endoscopy was performed, and biopsy specimens were examined by urease test and histological analysis. Twenty-two of 25 H. pylori-positive patients were assigned randomly to three groups. Group A patients were given oral ferrous sulfate and a 2-week course of bismuth subcitrate, amoxicillin, and metronidazole. Group B patients were given placebo for iron and a 2-week course of triple therapy. Group C patients were given oral ferrous sulfate and a 2-week course of placebo. Iron status was reassessed 4 weeks and 8 weeks after the 2-week regimen ended.

Results: Of the 43 subjects with iron-deficiency anemia, 25 (58.1%) had H. pylori in the antrum. Group A and B subjects, who received eradication therapy, showed a significant increase in hemoglobin level as compared with group C subjects at 8 weeks after therapy (p = .0086).

Conclusions: Treatment of H. pylori infection was associated with more rapid response to oral iron therapy as compared with the use of iron therapy alone. Such treatment also led to enhanced iron absorption even in those subjects who did not receive oral iron therapy.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Amoxicillin / therapeutic use
  • Anemia, Iron-Deficiency / complications
  • Anemia, Iron-Deficiency / drug therapy*
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Ulcer Agents / therapeutic use
  • Bismuth / therapeutic use*
  • Child
  • Double-Blind Method
  • Drug Therapy, Combination
  • Female
  • Ferrous Compounds / therapeutic use
  • Helicobacter Infections / complications
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori / drug effects
  • Hemoglobins / analysis
  • Humans
  • Intestinal Absorption / drug effects
  • Male
  • Metronidazole / therapeutic use
  • Nutritional Status
  • Organometallic Compounds / therapeutic use
  • Placebos
  • Pyloric Antrum / microbiology


  • Anti-Bacterial Agents
  • Anti-Ulcer Agents
  • Ferrous Compounds
  • Hemoglobins
  • Organometallic Compounds
  • Placebos
  • Metronidazole
  • ferrous sulfate
  • Amoxicillin
  • bismuth tripotassium dicitrate
  • Bismuth