Obesity Surgery

, Volume 18, Issue 11, pp 1450–1454

The Eradication of Helicobacter pylori is Affected by Body Mass Index (BMI)

  • Mohamed Abdullahi
  • Bruno Annibale
  • Danila Capoccia
  • Roberto Tari
  • Edith Lahner
  • John Osborn
  • Frida Leonetti
  • Carola Severi
Research Article

Abstract

Background

Bariatric surgeons often advocate preoperative Helicobacter pylori (H. pylori) testing and eradication because of the increased risk of postoperative ulcers and foregut symptoms in H. pylori-positive patients. The aim of this pilot study was to evaluate whether body mass index (BMI) might influence the success rate of eradication.

Methods

Eighty one nondiabetic naïve H. pylori-positive patients were divided into two groups according to their BMI, with 41 in the control group (normal BMI) and 40 in the overweight/obese group (BMI ≥25). Gastroscopy was performed and multiple biopsies were obtained from the antrum and corpus. Both groups were given a triple therapy consisting of pantoprazole 40 mg for 2 weeks plus amoxicillin 1 g tris in die (t.i.d), and clarithromycin 250 mg t.i.d, for the first week of treatment. Eradication was confirmed by the 13C-urea breath test at 3 months.

Results

Successful eradication was observed in 55.0% of the overweight/obese group compared with 85.4% [p < 0.005; odds ratio (OR): 4.77; 95% confidence interval (CI): 1.64–13.87]. The distribution of age, gender, and smoking, as well as the proportion with corpus predominant gastritis (41.4% and 35.0% in control and overweight/obese groups, respectively), did not differ significantly between the two groups. Regression analysis showed that risk factors for treatment failure were BMI (p < 0.02) with an OR of 1.06 (95% CI: 1.01–1.11) and corpus-predominant gastritis (p < 0.001) with an OR of 8.74 (95% CI: 2.48–30.8).

Conclusion

Overweight/obese nondiabetic patients showed a significantly lower rate of eradication rate of H. pylori infection than controls. BMI and corpus-predominant gastritis appear to be independent risk factors for eradication failure.

Keywords

Bariatric surgery Body mass index Helicobacter pylori eradication Obesity Overweight 

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Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Mohamed Abdullahi
    • 1
  • Bruno Annibale
    • 2
  • Danila Capoccia
    • 3
  • Roberto Tari
    • 1
  • Edith Lahner
    • 2
  • John Osborn
    • 4
  • Frida Leonetti
    • 3
  • Carola Severi
    • 1
  1. 1.Gastrointestinal Unit, Department of Clinical SciencesUniversity La SapienzaRomeItaly
  2. 2.Digestive and Liver Disease Unit, S. Andrea Hospital, 2nd Medical SchoolUniversity La SapienzaRomeItaly
  3. 3.Endocrinology Unit, Department of Clinical SciencesUniversity La SapienzaRomeItaly
  4. 4.Department of Public Health SciencesUniversity La SapienzaRomeItaly

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