Successful treatment of Helicobacter
pylori infection -- the bacteria linked to irritation of the stomach lining and
stomach ulcers -- may also resolve iron deficiency anemia, according to results
of an Italian study published in the November 2nd issue of the Annals of
Internal Medicine.
Lead author Dr. Bruno Annibale, a gastroenterologist at Rome's Policlinico
Umberto I, Universita La Sapienza, discussed the study with Reuters Health. He
explained that, in general, nearly one third of patients "undergoing
gastrointestinal investigation for iron deficiency anemia (IDA) remain without a
diagnosis," though there has been some association suggested between the
presence of H. pylori and iron deficiency anemia, based on epidemiological
evidence. Furthermore, several case reports have found that cure of H. pylori
infection appears to be accompanied by resolution of IDA. Iron deficiency anemia
is characterized by various findings including pallor, gastrointestinal
complaints, and abnormal blood test results.
In the current study involving 30 patients, "H. pylori-related gastritis
(was) the only pathological finding in a sizeable (number) of patients,"
Annibale told Reuters Health. No signs of ulcers were found. And, the patients
had not responded well to oral iron supplementation, a therapy that would have
been expected to improve the anemia.
According to Annibale, the researchers found that "cure of (H. pylori)
infection, by a 2-week (eradication) therapy, (led) to long-lasting recovery of
anemia with no further need of oral iron (supplementation)." At one year
post-treatment, nearly 92% of patients were free of anemia. Interestingly, "most
of our patients were premenopausal women in whom IDA (had been) considered by
(their) physicians solely due to menstrual blood (losses)," he added.
Given the results achieved in this study, Annibale believes that "H.
pylori infection must be considered as a possible cause of IDA... when... other
causes have been excluded by... hematological, gynecological, and
gastrointestinal... evaluation."
Annibale notes that additional research will be required to explain why
IDA seems to occur in relatively few patients with known H. pylori infection.
"The mechanism by which H. pylori determines IDA should also be elucidated," he
suggests, "particularly different... strains (of H. pylori) and their effects
on... levels of intragastric ascorbic acid."
Ascorbic acid, or vitamin C, is involved in the process of iron absorption
and H. pylori is known to "(cause) a considerable decrease in the concentration
of ascorbic acid in the gastric (fluids)," Annibale and colleagues write.
