Is there an association between Helicobacter pylori infection and irritable bowel syndrome? A meta-analysis  

作　　者：Qin Xiang Ng Nadine Xinhui Foo Wayren Loke Yun Qing Koh Vanessa Jing Min Seah Alex Yu Sen Soh Wee Song Yeo 

机构地区：[1]Medicine,MOH Holdings Pte Ltd,Singapore 099253,Singapore [2]General and Community Psychiatry,Institute of Mental Health,Singapore 117597,Singapore [3]Department of General Medicine,Tan Tock Seng Hospital,11 Jalan Tan Tock Seng,Singapore 308433,Singapore [4]Department of Gastroenterology and Hepatology,National University Hospital,National University Health System,Singapore 119074,Singapore [5]Yong Loo Lin School of Medicine,National University of Singapore,Singapore 117597,Singapore

出　　处：《World Journal of Gastroenterology》2019年第37期5702-5710,共9页世界胃肠病学杂志（英文版）

摘　　要：BACKGROUND Irritable bowel syndrome(IBS)is a prevalent and debilitating gastrointestinal condition.Research has reported persistent,low-grade mucosal inflammation and significant overlaps between patients with IBS and those with dyspepsia,suggesting a possible pathogenic role of Helicobacter pylori(H.pylori)in IBS.This study therefore aimed to provide the first systematic review and meta-analysis on the association between H.pylori infection and IBS.AIM To investigate the association between H.pylori infection and IBS.METHODS Using the keywords“H.pylori OR Helicobacter OR Helicobacter pylori OR infection”AND“irritable bowel syndrome OR IBS”,a preliminary search of PubMed,Medline,Embase,Cochrane Database of Systematic Reviews,Web of Science,Google Scholar and WanFang databases yielded 2924 papers published in English between 1 January 1960 and 1 June 2018.Attempts were also made to search grey literature.RESULTS A total of 13 clinical studies were systematically reviewed and nine studies were included in the final meta-analysis.Random-effects meta-analysis found a slight increased likelihood of H.pylori infection in patients with IBS,albeit this was not statistically significant(pooled odds ratio 1.47,95%confidence interval:0.90-2.40,P=0.123).It must also be acknowledged that all of the available studies reported only crude odd ratios.H.pylori eradication therapy also does not appear to improve IBS symptoms.Although publication bias was not observed in the funnel plot,there was a high degree of heterogeneity amongst the studies included in the meta-analysis(I2=87.38%).CONCLUSION Overall,current evidence does not support an association between IBS and H.pylori infection.Further rigorous and detailed studies with larger sample sizes and after H.pylori eradication therapy are warranted.BACKGROUND Irritable bowel syndrome(IBS) is a prevalent and debilitating gastrointestinal condition. Research has reported persistent, low-grade mucosal inflammation and significant overlaps between patients with IBS and those with dyspepsia,suggesting a possible pathogenic role of Helicobacter pylori(H. pylori) in IBS. This study therefore aimed to provide the first systematic review and meta-analysis on the association between H. pylori infection and IBS.AIM To investigate the association between H. pylori infection and IBS.METHODS Using the keywords "H. pylori OR Helicobacter OR Helicobacter pylori OR infection" AND "irritable bowel syndrome OR IBS", a preliminary search of PubMed, Medline, Embase, Cochrane Database of Systematic Reviews, Web of Science, Google Scholar and WanFang databases yielded 2924 papers published in English between 1 January 1960 and 1 June 2018. Attempts were also made to search grey literature.RESULTSA total of 13 clinical studies were systematically reviewed and nine studies were included in the final meta-analysis. Random-effects meta-analysis found a slight increased likelihood of H. pylori infection in patients with IBS, albeit this was not statistically significant(pooled odds ratio 1.47, 95% confidence interval: 0.90-2.40,P = 0.123). It must also be acknowledged that all of the available studies reported only crude odd ratios. H. pylori eradication therapy also does not appear to improve IBS symptoms. Although publication bias was not observed in the funnel plot, there was a high degree of heterogeneity amongst the studies included in the meta-analysis(I2 = 87.38%).CONCLUSION Overall, current evidence does not support an association between IBS and H.pylori infection. Further rigorous and detailed studies with larger sample sizes and after H. pylori eradication therapy are warranted.

关 键 词：IRRITABLE BOWEL SYNDROME Functional HELICOBACTER PYLORI INFECTION Metaanalysis 

分 类 号：R[医药卫生]