Digestive Diseases and Sciences

, Volume 56, Issue 2, pp 457–464

Effect of Helicobacter pylori Infection on Symptoms of Gastroenteritis Due to Enteropathogenic Escherichia coli in Adults

  • Alicia Hsin-Ming Chang
  • Thomas Dean Haggerty
  • Catherine de Martel
  • Cynthia Wai-Mun Leung
  • Julie Parsonnet
Original Article

DOI: 10.1007/s10620-010-1309-z

Cite this article as:
Chang, A.HM., Haggerty, T.D., de Martel, C. et al. Dig Dis Sci (2011) 56: 457. doi:10.1007/s10620-010-1309-z

Abstract

Background

Helicobacter pylori can cause hypochlorhydria in some hosts and predispose to diarrheal infections.

Aims

We tested the hypothesis that chronic H. pylori infection increases the risk of diarrheal illness due to an acid-sensitive organism: enteropathogenic Escherichia coli (EPEC).

Methods

After testing healthy adult volunteers for H. pylori, 19 infected and 26 uninfected subjects had gastric pH probes placed and were given 5–10 × 109 EPEC organisms; six had previously received a proton pump inhibitor. We measured diarrhea and created a composite gastroenteritis severity score based on symptoms in the 48 h following exposure. Outcomes were compared using logistic regression and analysis of covariance.

Results

More H. pylori-infected (36.8%) than H. pylori-uninfected subjects (7.7%) were hypochlorhydric (P = 0.02). Six (31.6%) H. pylori-infected and five H. pylori-uninfected subjects (19.2%) developed diarrhea (P = 0.34). Hypochlorhydria was a strong risk factor for diarrhea [odds ratio (OR) 6.25, confidence interval (CI): 1.29–30.35]. After adjusting for hypochlorhydria and EPEC dose, H. pylori was not associated with diarrhea (OR 0.89, CI: 0.17–4.58). Among those with symptoms, H. pylori-infected subjects had lower gastroenteritis severity score than did H. pylori-uninfected subjects (2.6, CI: 1.9–3.4 versus 1.5, CI: 1.1–1.9, P = 0.01), particularly if they were also hypochlorhydric (3.8, CI: 2.3–5.3 versus 1.9, CI: 1.3–2.5, P = 0.02).

Conclusions

In adults, H. pylori infection was associated with hypochlorhydria but had no detectable effect on occurrence of diarrhea. Among symptomatic subjects, H. pylori infection decreased severity of gastroenteritis.

Keywords

Helicobacter pylori Hypochlorhydria Gastroenteritis Enteropathogenic Escherichia coli Diarrhea Interaction 

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Alicia Hsin-Ming Chang
    • 1
    • 2
  • Thomas Dean Haggerty
    • 1
  • Catherine de Martel
    • 1
    • 3
  • Cynthia Wai-Mun Leung
    • 2
  • Julie Parsonnet
    • 1
    • 2
  1. 1.Division of Infectious Diseases and Geographic Medicine, Department of MedicineStanford UniversityStanfordUSA
  2. 2.Division of Epidemiology, Department of Health Research and PolicyStanford UniversityStanfordUSA
  3. 3.International Agency for Research on CancerLyon Cedex 08France

Personalised recommendations