Reversal of iron deficiency anemia after Helicobacter pylori eradication in patients with asymptomatic gastritis

Ann Intern Med. 1999 Nov 2;131(9):668-72. doi: 10.7326/0003-4819-131-9-199911020-00006.


Background: Iron deficiency anemia is the most common form of anemia worldwide. Recent studies have suggested an association between Helicobacter pylori infection and iron deficiency.

Objective: To investigate the effects of eradicating H. pylori with combination antibiotic therapy on iron deficiency anemia in patients with H. pylori-associated gastritis.

Design: Case series.

Setting: University hospital.

Patients: 30 patients with a long history of iron deficiency anemia in whom H. pylori-associated gastritis was the only pathologic gastrointestinal finding detected.

Intervention: Eradication therapy with two antibiotics and discontinuation of iron replacement therapy.

Measurements: Complete blood count, ferritin levels, and gastroscopy with biopsy to evaluate H. pylori status.

Results: At 6 months, 75% of patients had recovered from anemia (P<0.001), ferritin values increased from 5.7+/-0.7 microg/L to 24.5+/-5.2 microg/L (95% CI, 8.85 to 29.97). After 12 months, 91.7% of patients had recovered from anemia.

Conclusions: Cure of H. pylori infection is associated with reversal of iron dependence and recovery from iron deficiency anemia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / etiology*
  • Anti-Bacterial Agents*
  • Blood Cell Count
  • Drug Therapy, Combination / therapeutic use*
  • Female
  • Ferritins / blood
  • Gastritis / complications*
  • Gastritis / drug therapy*
  • Gastroscopy
  • Helicobacter Infections / complications*
  • Helicobacter Infections / drug therapy*
  • Helicobacter pylori*
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Treatment Outcome


  • Anti-Bacterial Agents
  • Ferritins