P1265 The correlation between Helicobacter pylori infection and iron deficiency in adults with inflammatory bowel disease in Taiwan
Authors: Wu Y H , Chou J W , Huang P J 
Published: January 2025

Abstract

Background
Iron deficiency anemia (IDA) effects around 45% of individuals with inflammatory bowel disease (IBD), encompassing ulcerative colitis (UC) and Crohn's disease (CD), detrimentally affecting their quality of life and imposing a considerable strain on the healthcare system. The pathophysiology of iron insufficiency in people with IBD is multifaceted, including intestinal hemorrhage, malabsorption, and insufficient oral intake. In adult populations, Helicobacter pylori (H. pylori)-induced atrophic gastritis is associated with decreased iron absorption owing to reduced stomach acid output, ultimately leading to IDA. The objective of this research was to assess the correlation between H. pylori infection and IDA in individuals with IBD.

Methods
A population-based research was performed using a random sample of one million beneficiaries from the National Health Insurance program. Individuals diagnosed with inflammatory bowel illness, iron deficiency anemia, and Helicobacter pylori infection were found from the National Health Insurance Research Database. The yearly prevalence and incidence of inflammatory bowel disease, iron deficiency anemia, and Helicobacter pylori infection in adults were assessed using International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes to identify pertinent cases from 2011 to 2020.

Results
This research comprised 5044 IBD patients, including 3724 with UC and 1253 with CD.Male patients constituted the majority of the patient population (62.7%). The mean age at diagnosis was 46.26±16.57 years. IDA included 14.02% of all IBD patients. A predominant proportion of these patients were female (68.13%).H. pylori infection represented 9.79% of all IBD patients, including 10.94% with CD and 9.41% with UC. The incidence of H. pylori infection in inflammatory bowel disease associated with iron deficiency anemia was 2.79%. The predominant number of these patients suffer from Crohn's disease.The mean hemoglobin levels in the H. pylori-positive cohort were significantly lower than those in the H. pylori-negative cohort. Research on logistic regression demonstrated a correlation between female sex and H. pylori infection with IDA.(Table 1.)

Conclusion
IDA in IBD results from insufficient intake, malabsorption and persistent hemorrhage due to mucosal ulcerations. Our research suggests that H. pylori infection may be a potential risk factor associated with IDA in IBD. Regular screening and diagnosis in these people are essential, as they often exhibit a combination of IDA and H. pylori infection, which may be beneficial for individuals with IBD. H. pylori eradication treatment, in conjunction with iron therapy, may enhance ferritin and hemoglobin concentrations.

References
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