H. pylori colonization protective against IBD

A meta-analysis has shown evidence supporting the protective benefit of Helicobacter pylori in inflammatory bowel disease (IBD). However, further studies using proper methodology are warranted to confirm this association.

The investigators performed a systematic search of studies to evaluate a possible association between H. pylori colonization and IBD. They searched seven databases and different types of gray literature. Selection and data extraction were carried out following the screening for relevant articles.

Subsequently, the investigators analysed the data and calculated the pooled odds ratios (ORs) through a meta-analysis. They also conducted heterogeneity, sensitivity, and subgroups analyses. Publication bias was assessed using funnel plots, followed by Begg and Egger tests.

Fifty-eight studies, including a total of 13,549 patients with IBD and 506,554 controls, met the eligibility criteria. The prevalence of H. pylori colonization among IBD patients and controls was 22.74 percent and 36.30 percent, respectively.

H. pylori colonization showed a significantly negative association with IBD (pooled OR, 0.45, 95 percent confidence interval [CI], 0.39–0.53; p≤0.001).

In the random-effect model, the included studies were found to have a significant statistical heterogeneity (I², 79 percent). No publication bias was noted.

ORs were markedly different among subgroups when the data were stratified by age difference between patients and controls, and by study regions and/or continent. Furthermore, the meta-regression analysis revealed significant results with regard to the age difference and region variables.