Influence of Helicobacter pylori Infection on the Small Intestinal Mucosa

Background/Aims. To investigate the role of Helicobacter pylori infection in the development of enteritis (small intestinal mucosal injury). Methodology. Between April 2007 and January 2013, 99 patients undergoing capsule endoscopy (CE) were tested for anti-H. pylori immunoglobulin G antibody (Hp-IgG) using an enzyme-linked immunosorbent assay (ELISA). None of the patients had been treated for H. pylori infection or diagnosed as having Crohn’s disease or any other clinically apparent small intestinal disorders prior to the CE. Results. The overall Hp-IgG-positive rate was 26.3%. The incidence of enteritis, as diagnosed by CE, tended to be lower in the Hp-IgG-positive patients (23.1%) than in the Hp-IgG-negative patients (38.4%) ( ). When patients receiving aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), well-known causes of enteritis, were excluded, the incidence of enteritis in the Hp-IgG-positive patients (11.7%) was significantly lower than that in the Hp-IgG-negative patients (43.7%) ( ). A binomial logistic regression analysis revealed a significant negative relationship between Hp-IgG positivity and the presence of enteritis in patients receiving neither aspirin nor NSAIDs ( ). Conclusions. Our data indicated that H. pylori positivity was inversely associated with the prevalence of enteritis. 1. Introduction Helicobacter pylori is a Gram-negative spiral-shaped microaerophilic bacterium that is known to colonize the gastric mucosa in humans [1]. Although H. pylori infection has been reported to be associated with an increased risk of gastric ulcer, duodenal ulcer, and atrophic gastritis [2, 3], little information is available on the possible association of H. pylori infection with enteritis (small intestinal mucosal injury). The aim of the present study was to assess the incidence of enteritis by capsule endoscopy (CE) in anti-H. pylori immunoglobulin G antibody (Hp-IgG)-positive and Hp-IgG-negative patients. 2. Methodology 2.1. Patients Between April 2007 and January 2013, Hp-IgG antibody was prospectively measured in 99 patients (70 men, 29 women; mean age, years; age range, 22–86 years) with obscure gastrointestinal bleeding (OGIB) at the Department of Gastroenterology, Dokkyo Medical University. Prior to July 2012, OGIB was the only indication for CE that was covered by the national health insurance system of Japan. Patients diagnosed as having Crohn’s disease, small bowel tumor, suspected ileus or gastrointestinal stricture, or radiation enterocolitis or having a history of intra-abdominal surgery or pacemaker implantation were