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Interaction between Helicobacter pylori and Non-Steroidal Anti-Inflammatory Drugs in Peptic Ulcer Bleeding

1999; Taylor & Francis; Volume: 34; Issue: 3 Linguagem: Inglês

10.1080/00365529950173618

1502-7708

Chun‐Ying Wu, Sek‐Kwong Poon, G. H. Chen, Chi‐Sen Chang, Hong‐Zen Yeh,

Gastric Cancer Management and Outcomes

Background: Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs) are the two primary causes of peptic ulcer disease. How H. pylori and NSAIDs interact and influence the development of ulcer bleeding is still not clear. Methods: A hospital-based, age- and sex-matched case-control study was conducted. Multivariate and stratified analyses were performed for further evaluation of the interaction between H. pylori and NSAIDs. Results: Ninety-seven patients (52 gastric ulcers, 45 duodenal ulcers) and 97 non-ulcer controls were enrolled in the study. H. pylori and NSAIDs were both found to be independent risk factors for ulcer bleeding (H. pylori odds ratio, 2.22; 95% confidence interval (CI), 1.23-4.01; NSAIDs odds ratio, 4.57; 95% CI, 2.50-8.35). There was no synergistic effect. In contrast, a negative interaction was observed in the logistic regression and stratified analysis, although the difference was not significant (H. pylori adjusted odds ratio, 3.47; 95% CI, 1.73-6.95; NSAID adjusted odds ratio, 6.16; 95% CI, 3.14-12.09). Conclusion: H. pylori increases the risk of peptic ulcer bleeding but may play a protective role in NSAID users.