Influence of Helicobacter pylori infection on the phenotype of Crohn's disease

Am J Gastroenterol. 1999 Nov;94(11):3239-44. doi: 10.1111/j.1572-0241.1999.01528.x.


Objective: Very little is known about the impact of Helicobacter pylori (H. pylori) infection on Crohn's disease. In this study we investigated a possible influence of H. pylori on the phenotype of Crohn's disease.

Methods: Patients with Crohn's disease who had gastric biopsy between 1990 and 1994 and a clinical follow-up in our outpatient clinic for at least 2 yr were included in the study. The mean number of flare-ups per year of follow-up, the mean numbers of intestinal resections per year of disease duration, and primary disease location were compared in H. pylori-positive and -negative patients. Various regression models were calculated to test the influence of H. pylori status on these parameters, correcting for smoking habits and disease duration.

Results: Of 131 patients, 50 (38.2%) were H. pylori positive and 62 (47.3%) were smokers. Due to a significant interaction between smoking habits and H. pylori infection, regression models were calculated separately for smokers and nonsmokers. Nonsmokers without H. pylori infection had more flare-ups than nonsmokers with H. pylori infection (0.77 [0.57-0.97] vs 0.29 [0.16-0.42]; p < 0.01; mean [95% confidence interval]). In contrast, nonsmokers without H. pylori infection had less intestinal resections than nonsmokers infected with H. pylori (0.08 [0.04-0.12] vs 0.11 [0.07-0.15]; p < 0.05). These differences were not significant for smokers (p < 0.41 and p < 0.07). There was a predominance of small bowel disease in H. pylori-positive patients, which did not reach statistical significance.

Conclusions: Our data indicate that H. pylori influences the phenotype of Crohn's disease, especially in nonsmokers.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Biopsy
  • Colonic Diseases / genetics
  • Colonic Diseases / microbiology
  • Colonic Diseases / pathology
  • Colonic Diseases / physiopathology
  • Confidence Intervals
  • Crohn Disease / genetics*
  • Crohn Disease / microbiology
  • Crohn Disease / pathology
  • Crohn Disease / physiopathology
  • Crohn Disease / surgery
  • Female
  • Follow-Up Studies
  • Gastroscopy
  • Helicobacter Infections / complications*
  • Helicobacter pylori*
  • Humans
  • Intestine, Small / microbiology
  • Intestine, Small / pathology
  • Intestine, Small / physiopathology
  • Logistic Models
  • Male
  • Phenotype
  • Poisson Distribution
  • Smoking / adverse effects
  • Stomach / microbiology
  • Stomach / pathology