The Frequency of Helicobacter pylori Infection in Gastric Biopsies of Patients with Gallbladder Stones

Abstract

Background

There were few studies reporting simultaneous presence of Helicobacter pylori (H. pylori) in stomach and gallbladder stones, most of which have been conducted on bile specimens or gallbladder tissues. Presence of a chronic inflammatory disease may contribute to gall stone formation through production of inflammatory cytokines. Chronic active gastritis due to H.pylori may contribute to lithogenesis in gallbladder. In this regard, the present study aimed to investigate the frequency and association of gastric H.pylori infection and gallstones in patients who were undergoing upper endoscopy in a teaching hospital.

Materials and Methods:

In this case-control study patients presenting with dyspeptic symptoms who underwent upper endoscopy during 2008-2012 in Shahid Beheshti Hospital of Babol, northern Iran were enrolled, 72 patients with and 136 patients without gallstones were assigned as the case and control groups, respectively. Patients with history of gastric surgery PPI, and antibiotic consumption four weeks before endoscopy were excluded from the study. Two biopsies were obtained from gastric antrum and body of each patient in both groups and examined histologically for gastritis and the presence of H. pylori. Then, endoscopic, histological and demographic features (age, gender, BMI, smoking, NSAID) in these two groups were compared. The SPSS software (version 18) was used for analysis. P-value of <0.05 was considered as statistically significant.

Results:

Fifty-two (72.2%) and 98 (72.1%) of all patients with and without gallstone were female, respectively (p=0.7). The mean age of patients with gallstone was 51.8±14 years, while it was 51.1±15 years in patients without gallstone (p = 0.9). H.pylori was detected in gastric mucosa of 31(43.1%) and 45 (33.8%) cases with and without gallstone, respectively. Although H.pylori infection was higher in patients with gallstones, the difference was not statistically significant (p =0.19). In the group with gallstones, 21 (29.2%) patients revealed severe gastritis, and in those without gallstones, 17 (12.5%) patients were found with severe gastritis. This difference was statistically significant (p =0.003, OR=2.88, CI: 1.41-5.91).

Conclusion:

This study demonstrates that patients with severe H.pylori induced gastritis are likely to have gallstone in comparison with mild gastritis. The frequency of H. pylori infection in patients with gallstones is more than those without gallstones.