Association between Helicobacter pylori infection and irritable bowel syndrome: a systematic review and meta-analysis

BackgroundHelicobacter pylori infection and irritable bowel syndrome (IBS) negatively affect the quality of life. Some previous studies found that H. pylori infection should be positively associated with the risk of IBS, but others did not. The present study aims to clarify this association, and to further analyse whether H. pylori treatment can improve IBS symptoms.Materials and methodsThe PubMed, EMBASE, Cochrane library, Chinese National Knowledge Infrastructure, China Science and Technology Journal and Wanfang databases were searched. Meta-analysis was performed using a random-effect model. The pooled odds ratios (ORs)/risk ratios (RRs) and their 95% CIs were calculated. Heterogeneity was evaluated using the Cochran’s Q test and I2 statistics. Meta-regression analysis was used to explore the sources of heterogeneity.ResultsThirty-one studies with 21 867 individuals were included. Meta-analysis of 27 studies found that patients with IBS had a significantly higher risk of H. pylori infection than those without (OR=1.68, 95% CI 1.29 to 2.18; p<0.001). The heterogeneity was statistically significant (I²=85%; p<0.001). Meta-regression analyses indicated that study design and diagnostic criteria of IBS might be the potential sources of heterogeneity. Meta-analysis of eight studies demonstrated that H. pylori eradication treatment had a higher improvement rate of IBS symptoms (RR=1.24, 95% CI 1.10 to 1.39; p<0.001). The heterogeneity was not significant (I²=32%; p=0.170). Meta-analysis of four studies also demonstrated that successful H. pylori eradication had a higher improvement rate of IBS symptoms (RR=1.25, 95% CI 1.01 to 1.53; p=0.040). The heterogeneity was not significant (I²=1%; p=0.390).ConclusionH. pylori infection is associated with an increased risk of IBS. H. pylori eradication treatment can improve IBS symptoms.

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Association betweenH. pyloriinfection and health Outcomes: an umbrella review of systematic reviews and meta-analyses

BMJ Open ◽

10.1136/bmjopen-2019-031951 ◽

2020 ◽

Vol 10 (1) ◽

pp. e031951

Author(s):

Liqun Li ◽

Jinjing Tan ◽

Lijian Liu ◽

Jianfeng Li ◽

Guangwen Chen ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Health Outcomes ◽

Systematic Reviews ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Umbrella Review ◽

Increased Risk ◽

H Pylori ◽

Irritable Bowel ◽

Meta Analyses

ObjectiveSystematic reviews and meta-analyses have revealed the associations betweenH. pyloriinfection and various health outcomes. We aimed to evaluate the strength and breadth of evidence on the associations.DesignUmbrella review of systematic reviews and meta-analyses.SettingNo settings.ParticipantsNo patients involved.Data sourcesEmbase, PubMed, Web of Science, Cochrane Library Databases, CNKI, VIP database and Wangfang database from inception to February 1, 2019.Outcomes measuresDiverse diseases (such as cancer and ischaemic heart disease).ResultsSixty articles reporting 88 unique outcomes met the eligible criteria. 74 unique outcomes had nominal significance (p<0.05). Of the outcomes with significance, 61 had harmful associations and 13 had beneficial associations. Furthermore, 73% (64) of the outcomes exhibited significant heterogeneity . Of the these meta-analyses, 32 had moderate to high heterogeneity (I2=50%–75%) and 24 had high heterogeneity (I2>75%). Moreover, 20% exhibited publication bias (p<0.1). In addition, 97% of the methodological qualities were rated ‘critically low’. 36% of the evidence qualities of outcomes were rated ‘low’, 56% of the evidence qualities were rated ‘very low’ and 8% of the evidence qualities were rated ‘moderate’.H. pyloriinfection may be associated with an increased risk of five diseases and a decreased risk of irritable bowel syndrome.ConclusionAlthough 60 meta-analyses explored 88 unique outcomes, moderate quality evidence only existed for six outcomes with statistical significance.H. pyloriinfection may be associated with a decreased risk of irritable bowel syndrome and an increased risk of hypertriglyceridemia, chronic cholecystitis and cholelithiasis, gestational diabetes mellitus, gastric cancer and systemic sclerosis.Trial registrationCRD42019124680.

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Risk for Irritable Bowel Syndrome in Patients with Helicobacter Pylori Infection: A Nationwide Population-Based Study Cohort Study in Taiwan

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103737 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3737

Author(s):

Chia-Ming Liang ◽

Chih-Hsiung Hsu ◽

Chi-Hsiang Chung ◽

Chao-Yang Chen ◽

Lin-Yin Wang ◽

...

Keyword(s):

Helicobacter Pylori ◽

Irritable Bowel Syndrome ◽

Cohort Study ◽

Cumulative Incidence ◽

Eradication Therapy ◽

Research Database ◽

Increased Risk ◽

Comparison Cohort ◽

H Pylori ◽

Irritable Bowel

Background: The association between Helicobacter pylori (H. pylori) infection and the risk of developing irritable bowel syndrome (IBS) has yet to be investigated; thus, we conducted this nationwide cohort study to examine the association in patients from Taiwan. Methods: A total of approximately 2669 individuals with newly diagnosed H. pylori infection and 10,676 age- and sex-matched patients without a diagnosis of H. pylori infection from 2000 to 2013 were identified from Taiwan’s National Health Insurance Research Database. The Kaplan–Meier method was used to determine the cumulative incidence of H. pylori infection in each cohort. Whether the patient underwent H. pylori eradication therapy was also determined. Results: The cumulative incidence of IBS was higher in the H. pylori-infected cohort than in the comparison cohort (log-rank test, p < 0.001). After adjustment for potential confounders, H. pylori infection was associated with a significantly increased risk of IBS (adjusted hazard ratio (aHR) 3.108, p < 0.001). In addition, the H. pylori-infected cohort who did not receive eradication therapy had a higher risk of IBS than the non-H. pylori-infected cohort (adjusted HR 4.16, p < 0.001). The H. pylori-infected cohort who received eradication therapy had a lower risk of IBS than the comparison cohort (adjusted HR 0.464, p = 0.037). Conclusions: Based on a retrospective follow-up, nationwide study in Taiwan, H. pylori infection was associated with an increased risk of IBS; however, aggressive H. pylori infection eradication therapy can also reduce the risk of IBS. Further underlying biological mechanistic research is needed.

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The Association between Helicobacter pylori Infection and Irritable Bowel Syndrome: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17072524 ◽

2020 ◽

Vol 17 (7) ◽

pp. 2524

Author(s):

Yun-A Kim ◽

Yoon Jeong Cho ◽

Sang Gyu Kwak

Keyword(s):

Helicobacter Pylori ◽

Irritable Bowel Syndrome ◽

Meta Analysis ◽

Case Control ◽

Case Control Studies ◽

Cross Sectional ◽

Cross Sectional Studies ◽

H Pylori ◽

Irritable Bowel ◽

The Relationship

The association of Helicobacter pylori (H. pylori) infection with functional dyspepsia has been well studied. However, the data on the relationship between H. pylori infection and irritable bowel syndrome (IBS) are conflicting. This study aims to elucidate the association between H. pylori infection and IBS. PubMed, Cochrane Library, CINAHL and SCOPUS databases were searched to identify eligible English articles published up to December 2019. Cross-sectional studies, case–control studies and cohort studies reporting both prevalence of H. pylori infection and IBS were selected for the detailed review. The pooled odds ratio (ORs) and their 95% confidence interval (CI) were calculated. A total of 7269 individuals in four cross-sectional studies and six case-control studies were included. The prevalence of H. pylori infection ranged from 12.8% to 73.4% in the control group, and 9.7% to 72.1% in the IBS group. The combined OR for H. pylori infection was 1.10 (95% CI: 0.93–1.29, I2: 37.5%). In a subgroup analysis of IBS defined according to Rome criteria, the OR for H. pylori infection was 1.10 (95% CI: 0.93–1.30, I2 = 31.7%). In this meta-analysis, H. pylori infection was not significantly associated with IBS. Well-designed studies are needed to identify the relationship between H. pylori infection and IBS.

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Safety of furazolidone-containing regimen in Helicobacter pylori infection: a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-037375 ◽

2020 ◽

Vol 10 (10) ◽

pp. e037375

Author(s):

Chao-ran Ji ◽

Jing Liu ◽

Yue-yue Li ◽

Chuan-guo Guo ◽

Jun-yan Qu ◽

...

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Data Extraction ◽

Meta Analysis ◽

Treatment Discontinuation ◽

Cochrane Library ◽

Eligibility Criteria ◽

Increased Risk ◽

Daily Dose ◽

H Pylori

ObjectivesFurazolidone containing regimen is effectivefor Helicobacter pylori (H. pylori) infection, but its safetyremains controversial. To assess the safety of furazolidone containing regimenin H. pylori infection.DesignA systematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, Web of Science and Scopus databases were systematically searched for eligible randomised controlled trials.Eligibility criteriaStudies comparing furazolidone with non-furazolidone-containing regimen, variable durations or doses of furazolidone were included.Data extraction and synthesisTwo reviewers independently selected studies and extracted data. Primary outcomes were the risk of total adverse events (AEs), serious AEs and severe AEs, expressed as relative risk (RR) with 95% CI. Secondary outcomes contained the incidence of individual adverse symptoms, AE-related treatment discontinuation and compliance.ResultsTwenty-six articles were identified from 2039 searched records, of which 14 studies (n=2540) compared furazolidone with other antibiotics. The eradication rates of furazolidone-containing regimen were higher than those of other antibiotics in both intention-to-treat (RR 1.06, 95% CI 1.01 to 1.12) and per-protocol analysis (RR 1.05, 95% CI 1.00 to 1.10). Only two serious AEs were reported in furazolidone group (2/1221, 0.16%). No significant increased risk was observed for the incidence of total AEs (RR 1.04, 95% CI 0.89 to 1.21) and severe AEs (RR 1.81, 95% CI 0.91 to 3.60). Twelve studies (n=3139) compared different durations of furazolidone, and four studies (n=343) assessed variable doses. Elevated risk of total AEs and severe AEs were only found in a high daily dose of furazolidone rather than prolonged duration. The incidence of AE-related treatment discontinuation and compliance of patients were all similar, irrespective of dose and duration adjustments.ConclusionFurazolidone-containing regimen has a similar risk of AEs and compliance as non-furazolidone-containing regimen. A low daily dose of 200 mg is well-tolerated for 14 day regimen and should be first considered.PROSPERO registration numberCRD42019137247

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The Relationship between Helicobacter pylori Infection of the Gallbladder and Chronic Cholecystitis and Cholelithiasis: A Systematic Review and Meta-Analysis

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2021/8886085 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Liang Wang ◽

Junyin Chen ◽

Wenxi Jiang ◽

Li Cen ◽

Jiaqi Pan ◽

...

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Subgroup Analysis ◽

Meta Analysis ◽

Chronic Cholecystitis ◽

Cochrane Library ◽

Positive Correlation ◽

Increased Risk ◽

H Pylori ◽

The Relationship

Helicobacter pylori (H. pylori) is proved to be the main pathogenic agent of various diseases, including chronic gastritis, gastric ulcer, duodenal ulcer, and gastric cancer. In addition, chronic cholecystitis and cholelithiasis are common worldwide, which are supposed to increase the total mortality of patients. Epidemiologic evidence on the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis still remains unclear. We conducted a systematic review and meta-analysis of overall studies to investigate the relationship between H. pylori infection of the gallbladder and chronic cholecystitis/cholelithiasis. Two researchers searched PubMed, Embase, and Cochrane Library databases to obtain all related and eligible studies published before July 2020. The pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated by the random-effects model. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also conducted. Twenty studies were included in the meta-analysis, involving 1735 participants and 1197 patients with chronic cholecystitis/cholelithiasis. Helicobacter species infection of the gallbladder was positively correlated with increased risk of chronic cholecystitis and cholelithiasis, especially H. pylori (OR = 3.05; 95% CI, 1.81–5.14; I2 = 23.5%). Besides, country-based subgroup analysis also showed a positive correlation between the gallbladder H. pylori positivity and chronic cholecystitis/cholelithiasis risk. For Asian and non-Asian country studies, the ORs were 4.30 (95% CI, 1.76–10.50; I2 = 37.4%) and 2.13 (95% CI, 1.23–3.70; I2 = 0.0%), respectively. The association was more obvious using the bile sample and urease gene primer. In conclusion, this meta-analysis provided evidence that there is a positive correlation between H. pylori infection in the gallbladder and increased risk of chronic cholecystitis and cholelithiasis.

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Two-Way Relationship Between Helicobacter Pylori Infection and Periodontitis: Results from A Systematic Review and Meta-Analysis

10.31487/j.cei.2020.01.03 ◽

2020 ◽

pp. 1-7

Author(s):

Felipe Rodolfo ◽

Silvania Conceição Furtado ◽

Alessandro Luiz Araújo Bentes Leal ◽

Any Carolina Cardoso Guimarães Vasconcelos ◽

Daniel Fernando Pereira Vasconcelos ◽

...

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Meta Analysis ◽

Current Systematic Review ◽

Increased Risk ◽

Statistical Program ◽

H Pylori ◽

Ci Calculations ◽

Review Manager

Aim: Helicobacter pylori (H. pylori) infection and periodontitis have considerable worldwide prevalence once they both present systemic alterations with a possible association between them. Therefore, we have performed this meta-analysis to assess the possible association between H. pylori infection and periodontitis. Material and Methods: A systematic search in the literature was performed for studies published before December 2, 2019 in diverse scientific and educational databases. The data was extracted by two investigators and the statistical analysis was performed by Review Manager statistical program with heterogeneity and Odds Ratio (OR) with 95% of Confidence Intervals (CI) calculations as well as a sensitive analysis to assess the accuracy of the results. The value of P<0.05 was considered as significant. In addition, we performed the analysis of the quality of included studies as well as the evaluation for risk of bias. Results: In overall analysis, H. pylori infection was associated with the risk of periodontitis development (OR = 1.72, CI: 1.47, 2.02, P<0.00001) and the periodontitis was considered as a risk factor for H. pylori infection (OR = 3.21, CI: 2.31, 4.47, P<0.00001). Moreover, the evaluation of dental plaque from patients with periodontitis reveled increased risk of H. pylori infection (OR = 3.46, CI: 2.39, 5.01, P<0.00001). Conclusions: This current systematic review and meta-analysis composed by 12 studies in 7,059 participants showed that H. pylori infection increased significantly the risk of the development of periodontitis and the periodontitis may be a risk for this bacterial infection.

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Candidate single nucleotide polymorphisms of irritable bowel syndrome: a systemic review and meta-analysis

BMC Gastroenterology ◽

10.1186/s12876-019-1084-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Shiwei Zhu ◽

Ben Wang ◽

Qiong Jia ◽

Liping Duan

Keyword(s):

Irritable Bowel Syndrome ◽

Single Nucleotide Polymorphisms ◽

Meta Analysis ◽

Systemic Review ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Genetic Studies ◽

Increased Risk ◽

Rome Iii ◽

Irritable Bowel

Abstract Background Genetic factors increase the risk of irritable bowel syndrome (IBS). Analysis of single nucleotide polymorphisms (SNPs) has been used in IBS patients, but the findings are inconsistent. The goal of this review was to synthesize all the published SNPs studies of IBS through meta-analysis to objectively evaluate the relevance of SNPs to IBS risks. Methods IBS - related polymorphisms studies from 2000 to 2018 were searched. Pooled odds ratios with a 95% confidence interval for each SNP were evaluated through five genetic models. Ethnicity, ROME criteria and IBS subtypes were defined for subgroup analyze. Results Ten relevant genes were evaluated. SNPs rs4263839 and rs6478108 of TNFSF15 associated with an increased risk of IBS; IL6 rs1800795 increased the risk for Caucasian IBS patients which diagnosed by Rome III criteria; and IL23R rs11465804 increased the risk for IBS-C patients. IL10 rs1800896 GG genotype associated with a decreased risk of IBS. No evidence supported the association of GNβ3 rs5443, TNFα rs1800629, and IL10 rs1800871 to IBS in this study. Conclusions This meta-analysis presents an in-depth overview for IBS SNPs analysis. It was confirmed that polymorphisms of TNFSF15 associated with increased IBS risk, while IL10 rs1800896 associated with decreased IBS risk. It might offer some insights into polymorphisms of inflammation factors which might affect IBS susceptibility. Moreover, the analysis also emphasizes the importance of diagnostic criteria and phenotype homogeneity in IBS genetic studies.

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Psychological Therapies in Patients with Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Gastroenterology Research and Practice ◽

10.1155/2015/549308 ◽

2015 ◽

Vol 2015 ◽

pp. 1-19 ◽

Cited By ~ 24

Author(s):

Osama Altayar ◽

Varun Sharma ◽

Larry J. Prokop ◽

Amit Sood ◽

Mohammad Hassan Murad

Keyword(s):

Quality Of Life ◽

Irritable Bowel Syndrome ◽

Randomized Controlled Trials ◽

Random Effect Model ◽

Controlled Trials ◽

Randomized Controlled ◽

Psychological Therapies ◽

Increased Risk ◽

Irritable Bowel

Background. Irritable bowel syndrome (IBS) is a poorly understood disease with few effective treatments. Psychosocial factors are believed to contribute to the pathogenesis of IBS.Objective. To evaluate the evidence for psychological therapies in IBS treatment.Methods. We searched six medical databases through February 6, 2014, for randomized controlled trials (RCTs) of psychological therapies for the treatment of IBS. Two independent reviewers identified the RCTs, extracted the data, and assessed trial quality. We used the random-effect model to pool standardized mean difference (SMD) and 95% confidence interval (CI) across trials.Results. 15 RCTs that mostly evaluated cognitive behavioral therapy were included. Psychological therapies were associated with improvement in IBS symptoms severity scales (SMD −0.618; 95% CI: −0.853 to −0.383), IBS-Quality of Life (SMD 0.604; 95% CI: 0.440 to 0.768), and abdominal pain (SMD −0.282; 95% CI: −0.562 to −0.001). No statistically significant effect was observed on diarrhea or constipation.Limitations. The trials were at increased risk of bias and the overall sample size was small leading to imprecision.Conclusion. Psychological therapies may improve the quality of life and symptom severity in IBS. The effect size noted is moderate to large and is clinically meaningful.

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Association Between Irritable Bowel Syndrome and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis

Frontiers in Neurology ◽

10.3389/fneur.2021.720958 ◽

2021 ◽

Vol 12 ◽

Author(s):

XinYue Zhang ◽

Zhen Svn ◽

MengSi Liv ◽

Yan Yang ◽

Rui Zeng ◽

...

Keyword(s):

Systematic Review ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Irritable Bowel Syndrome ◽

Meta Analysis ◽

Underlying Mechanism ◽

Cochrane Library ◽

Bowel Diseases ◽

Newcastle Ottawa Scale ◽

Irritable Bowel

Background: Parkinson's disease (PD) and irritable bowel syndrome (IBS) are respectively one of the most common neurodegenerative diseases and functional bowel diseases in the world. Recent studies suggest that patients with IBS seem to have a higher risk of PD, which conflicts with the result of previous meta-analysis. Therefore, the purpose of this systematic review is to evaluate all available evidence, in order to clarify the association between PD and IBS.Methods: Two reviewers independently searched the PubMed, Embase, Web of Science, and Cochrane library on April 25, 2021 to identify all records that explore the association between IBS and PD. All reports that clearly define PD and IBS and analyze the relationship between the two were included. The Newcastle-Ottawa scale was used to assess the risk of bias of included studies.Results: Five studies from four articles involving 2,044,110 subjects were included in this analysis. The pooled results demonstrated a significant association between PD and IBS (1.48; 95% CI: 1.35–1.62, P < 0.001), with subtle heterogeneity (I2 = 0.0%, p = 0.585). The association was observed across genders and increased with age. However, the available evidence cannot allow a reliable analysis of the causal relationship between IBS and PD.Conclusion: This study demonstrates a higher risk of PD among subjects with IBS. Future studies are required to further clarify the causation and underlying mechanism of the association.

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Alterations in short-chain fatty acids and serotonin in irritable bowel syndrome: a systematic review and meta-analysis

BMC Gastroenterology ◽

10.1186/s12876-020-01577-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mei Luo ◽

Xiaojun Zhuang ◽

Zhenyi Tian ◽

Lishou Xiong

Keyword(s):

Fatty Acids ◽

Irritable Bowel Syndrome ◽

Meta Analysis ◽

Short Chain Fatty Acids ◽

Short Chain ◽

Cochrane Library ◽

Case Control Studies ◽

Mean Differences ◽

Irritable Bowel ◽

Chain Fatty Acids

Abstract Background Short-chain fatty acids (SCFAs) and serotonin (5-hydroxytryptamine, 5-HT) may be associated with the pathogenesis of irritable bowel syndrome (IBS). There are some reports of alterations in SCFAs and 5-HT in IBS, but their results are inconsistent. We aimed to perform a meta-analysis to assess alterations in SCFAs and 5-HT in IBS patients and their potential role in the abnormal brain-gut-microbiota (BGM) axis. Methods Case–control studies detecting SCFAs and 5-HT in IBS patients were identified from PubMed, Web of Science, Cochrane Library, and Scopus databases to identify relevant articles up to September 2018. The standardized mean differences (SMDs) with 95% confidence intervals (CIs) of SCFAs and 5-HT were calculated by REVIEW MANAGER 5.3 to evaluate the alterations of 5-HT and SCFAs in IBS. Results Five studies on SCFAs and 5 on 5-HT in IBS patients were included. As compared to healthy controls (HCs), the SMDs of 5-HT in IBS patients was 2.35 (95% CI 0.46–4.24) and the SMDs of total SCFAs, acetic acid, propionic acid, and butyric acid in IBS patients were − 0.01 (95% CI − 0.57–0.55), − 0.04 (95% CI − 0.55–0.47), 0.07 (95% CI − 0.45–0.60), and − 0.00 (95% CI − 0.49–0.49), respectively. Conclusions There was an increase in 5-HT in blood of IBS patients, indicating the increased 5-HT in blood may be involved in IBS pathogenesis. However, there were no significant differences in SCFAs in feces between IBS patients and HCs. But the study did not differentiate between subgroups of IBS. These findings might provide insight for future studies of the BGM axis in the pathogenesis of IBS. Mei Luo and Xiaojun Zhuang contributed equally to the writing of this article

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