Agustos 2021
Helicobacter pylori ve inflamatuvar bagirsak hastaligi arasindaki iliski
Relationship between Helicobacter pylori infection and inflammatory bowel disease
- Ana Sayfa
- Sayılar
- Agustos 2021
- Helicobacter pylori ve inflamatuvar bagirsak hastaligi arasindaki iliski...
Erzurum Egitim ve Arastirma Hastanesi 2Gastroenteroloji Klinigi, Erzurum
Özet
Giris ve Amaç: Kronik Helicobacter pylori enfeksiyonunun, sistematikimmün toleransi indükleyerek ve inflamatuvar tepkileri baskilayarakinflamatuvar bagirsak hastaligina karsi korumada bir rol oynadigi ilerisürülmektedir. Çalismanin birincil amaci inflamatuvar bagirsak hastali-gi olgularinda Helicobacter pylori sikligini saptamaktir. Ikincil amaci iseinflamatuvar bagirsak hastaligi ve Helicobacter pylori enfeksiyonu arasindaki iliskiyi arastirmaktir. Gereç ve Yöntem: Inflamatuvar bagirsakhastaligi tanisi ile takip edilen, dispepsi nedeni ile üst gastrointestinalsistem endoskopisi yapilan 18 yas üzeri hastalarin verileri retrospektifolarak incelenerek olgular çalismaya dahil edildi. Kontrol grubu inflamatuvar bagirsak hastaligi tanisi olmayan ve dispepsi nedeni ile üstgastrointestinal sistem endoskopisi yapilan olgulardan olusturuldu. Tümhastalarin yas, cinsiyet, üst gastrointestinal sistem endoskopide alinanbiyopsi örneklerinin patolojik degerlendirme sonucundaki Helicobacterpylori varligi, atrofik gastrit ve intestinal metaplazi varligi bulgulari kaydedildi. Her iki grup Helicobacter pylori sikligi ve histopatolojik bulgular(intestinal metaplazi ve atrofik gastrit varligi) yönünden karsilastirildi.Bulgular: Yüz altmis inflamatuvar bagirsak hastasi ve 60 kontrol olmaküzere toplam 220 olgu çalismaya dahil edildi. Inflamatuvar bagirsakhastaligi olgularinin %53.8’i (n=86) ülseratif kolit, %46.2’si (n=74) Crohn hastaligi tanili olgulardi. Inflamatuvar bagirsak hastaligi grubundaHelicobacter pylori orani kontrol grubu ile karsilastirildiginda anlamliolarak daha düsük saptandi (%52.5’e karsi %73.3 ve p = 0.005). Inflamatuvar bagirsak hastaligi grubunda atrofik gastrit orani kontrol grubuile karsilastirildiginda anlamli olarak daha düsük bulundu (%3.1’e karsi%15 ve p = 0.001). Inflamatuvar bagirsak hastaligi grubunda intestinalmetaplazi orani kontrol grubu ile karsilastirildiginda anlamli olarak dahadüsüktü (%1.9’a karsi %11.7 ve p = 0.002). Sonuç: Inflamatuvar bagirsak hastaligi grubunda anlamli olarak daha düsük oranda Helicobacterpylori pozitifligi saptanmistir. Ayni sekilde, inflamatuvar bagirsak hastaligi grubunda daha düsük oranda atrofik gastrit ve intestinal metaplazivarligi saptanmistir. Inflamatuvar bagirsak hastaligi olgularinda tedavide kullanilan antibiyotiklerin Helicobacter pylori sikligini azaltarak dahaaz siklikta atrofik gastrit ve intestinal metaplazi gelisimine yol açtiginidüsünmekteyiz.
Abstract
Background and Aims: It has been suggested that chronic Helicobacter pylori infection plays a protective role against inflammatory bowel disease by inducing systemic immune tolerance and suppressing inflammatory responses. The primary aim of the study was to determinethe frequency of Helicobacter pylori in inflammatory bowel diseasepatients. A secondary aim was to investigate the relationship betweeninflammatory bowel disease and Helicobacter pylori infection. Materials and Methods: Patients over 18 years of age who were in follow-upwith a diagnosis of inflammatory bowel disease and who underwentupper gastrointestinal system endoscopy for dyspepsia were includedin the study and their data retrospectively analyzed. The control groupconsisted of patients who were not diagnosed with inflammatory bowel disease and had upper gastrointestinal system endoscopy for dyspepsia. For all patients, age; gender; and the presence of Helicobacter pylori, atrophic gastritis, and intestinal metaplasia as a result of pathologicalevaluation of biopsy samples taken by upper gastrointestinal systemendoscopy were recorded. Both groups were compared in terms ofHelicobacter pylori frequency and histopathological findings (presenceof intestinal metaplasia and atrophic gastritis). Results: A total of 220cases, including 160 inflammatory bowel disease and 60 controls, wereincluded in the study. In all, 53.8% (n = 86) of inflammatory boweldisease patients were diagnosed with ulcerative colitis and 46.2% (n= 74) with Crohn’s disease. The rate of Helicobacter pylori was foundto be significantly lower in the inflammatory bowel disease group compared with the control group (52.5% versus 73.3% and p = 0.005). Therate of atrophic gastritis was significantly lower in the inflammatorybowel disease group compared with the control group (3.1% vs 15%and p = 0.001). The intestinal metaplasia rate was significantly lowerin the inflammatory bowel disease group compared with the controlgroup (1.9% vs 11.7% and p = 0.002). Conclusion: Helicobacter pyloripositivity was found at a significantly lower rate in the inflammatorybowel disease group. The presence of atrophic gastritis and intestinalmetaplasia was found to be lower in the inflammatory bowel diseasegroup. We believe that antibiotics used in the routine treatment ofinflammatory bowel disease patients decrease the frequency of Helicobacter pylori and lead to less frequent development of atrophic gastritisand intestinal metaplasia
