Protective Effect of H pylori Infection in Non-Steroidal Anti-Inflammatory Drug Users

Non-steroidal anti-inflammatory drug (NSAID) use and H pylori infection are two major causes of peptic ulcers. This study investigates the effect of H pylori infection and NSAIDs on gastroduodenal damages and bleeding (GIB). 104 patients with acute gastrointestinal bleeding (GIB) and 102 patients with dyspepsia without bleeding were studied. Duodenal (DU) and gastric ulcers (GU) were identified by endoscopy and H pylori infection by histologic examination of biopsy samples. Association of NSAID and H pylori with DU, GU and/or GIB was determined by calculation of odds ratio. The percentages of NSAID-users in patients with and without GIB were 50% and 34% respectively. DU and GU were more frequent in patients with GIB than those without bleeding (P<0.001). In NSAID-users, the percentages of DU as well as GIB were significantly higher as compared with non-users (P<0.02). Concerning H pylori-infected as compared to non-infected patients, the prevalence of DU was significantly higher (P<0.000). The percentage of GU was significantly lower (P<0.02). DU was significantly higher in NSAID-users who were infected with H pylori than those of non-infected (P<0.001), but such a relationship was reversed with respect to GU (P<0.015). However, the rate of GIB in this group was not decreased significantly. H pylori infection increased the risk of DU in NSAID users, whereas, it decreased the risks of GU and GIB in NSAID and GU in non users.