The Relationship Between Helicobacter Pylori Infection And Inflammatory Bowel Disease: A Meta-analysis

Objective:There is controversial evidence on the relationship between Helicobacter pyloriinfection and inflammatory bowel disease. The present study was done to systematicallyreview the relationship between Helicobacter pylori infection and inflammatory boweldisease.Methods:We searched Medline，Pubmed,Cochrance Collaboration database, CNKI and Wanfangin the year of l994to2012. Meta-analyses were performed for the included case-controlstudies using RevMan5.1software after strict screening, estimating ORs and95%Cls forthe association between Helicobacter pylori infection and inflammatory bowel disease. Wealso performed heterogeneity test, sensitivity analysis and publication bias assessment.Results:Twenty-six eligible studies, including twenty-two studies carried by foreigners, and fourby Chinese researchers, were included in the meta-analysis, involving2820patients withIBD(1716patients with CD,1104patients with UC). Overall,29.3%of IBD patients hadevidence of infection with Helicobacter pylori compared to47.6%of patients in the controlgroup. The results of meta-analyses showed that there was a significant difference in theinfection ratio of Helicobacter pylori between the patients with IBD and healthcontrols[P<0.001, OR=0.39,95%CI (0.33-0.47)]. Eighteen studies on Helicobacter pyloriinfection and Ulcerative colitis were also collected. It was showed that there was stasticalydifference between the patients with UC and health controls[P<0.001, OR=0.45,95%CI（0.36-0.57)]. Mata-analysis also concluded there was statistical difference between thepatients with CD and health controls [P<0.001，OR=0.34，95%Cl（0.27-0.44)]. There wassome heterogeneity in the outcomes between Helicobacter pylori infection and inflammationbowel disease as well as its subtypes, Random-effects model was adopted to performheterogeneity test because of significant study heterogeneity. Sensitivity analysis andsubgroup analysis suggested the results of meta-analysis were reliable．However，the funnelplots suggested that the experimental results may be affected by bias. Conclusions:These results suggest a protective benefit of Helicobacter pylori infection against thedevelopment of IBD and reveal a statistically significant reduction in the Helicobacter pyloriinfection in CD patients diagnosed compared to the patients with UC. our review suggests apossible protective benefit of Helicobacter pylori infection against the development of IBD,especially in developing countries.