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Helicobacter pylori infection is associated with reduced prevalence of colonic diverticular disease
Author(s) -
Bartels Lars Erik,
Jepsen Peter,
Tøttrup Anders,
Vilstrup Hendrik,
Dahlerup Jens Frederik
Publication year - 2017
Publication title -
helicobacter
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 79
eISSN - 1523-5378
pISSN - 1083-4389
DOI - 10.1111/hel.12384
Subject(s) - medicine , diverticular disease , helicobacter pylori , incidence (geometry) , gastroenterology , disease , etiology , diverticulosis , urea breath test , breath test , confounding , helicobacter pylori infection , physics , optics
Background Colonic diverticular disease is a common disorder with increasing incidence in Western societies. The intestinal microbiome may be among etiological factors. Helicobacter pylori may protect against some intestinal diseases, and incidence of H. pylori is decreasing in Western societies. Thus, we aimed to determine whether H. pylori is associated to decreased prevalence of registered colonic diverticular disease. Materials and Methods In a historical cohort study, patients were enrolled from primary health care centers after urea breath test for H. pylori and then followed for a median of 6 years. The patient's diagnostic codes and country of birth were acquired from nationwide Danish administrative registries. We used logistic regression to compare prevalence and Cox regression to compare incidence of diverticular disease between H. pylori ‐positive and H. pylori ‐negative patients, adjusting for confounding variables. Results Patients infected with H. pylori had lower prevalence of colonic diverticular disease (0.87% vs 1.14%, OR =0.62, 95% CI : 0.50‐0.78). This phenomenon was observed whether we studied all registered diagnoses or only cases registered as primary diagnoses at discharge. After urea breath test, we observed no statistical difference in incidence rates of diverticular disease. Conclusion H. pylori is associated with reduced prevalence of colonic diverticular disease. The inverse association was absent after the urea breath test. Thus, we speculate that H. pylori may provide protection from colonic diverticular disease. Alternatively, H. pylori is a marker for other factors affecting disease development.