Gastrointestinal manifestations of allergy in the presence of Helicobacter pylori infection

Abstract

Association of Helicobacter pylori infection with gastrointestinal tract disorders is one of the most common problems in the modern medicine. There are conflicting data in the literature on the role of H. pylori infection in development of allergic diseases and its effect on the course of gastrointestinal disorders in allergic conditions. There is currently no conclusive evidence about the role of H. pylori in etiology and pathogenesis of allergic states. Hence, the studies of gastrointestinal disorders in allergic conditions in the presence of H. pylori infection are of sufficient relevance. Our aim was to study the features of sensitization spectrum and clinical course of gastrointestinal manifestations in allergic disorders in the children infected with H. pylori. We have carried out a retrospective analysis of medical histories of the children with gastrointestinal manifestations of allergies (n = 29) aged from 1 to 18 years (middle age, 110.7 years), living in Eastern Siberia. The presence of H. pylori infection was determined with enzyme immunoassay technique, by measuring concentrations of total antibodies to the CagA H. pylori antigen. Depending on the carriage of H. pylori infection, 2 groups were discerned: HP-infected (n = 8), and HP-non-infected patients (n = 21). The spectrum of sensitization was determined by evaluating skin-prick tests for the non-infectious allergens. Gastrointestinal tract evaluation was based on the results of anamnesis, complaints, objective examination and data of esophagogastroduodenoscopy. It was found that, in most cases, gastrointestinal manifestations of allergy were combined with dermatorespiratory syndrome (41.3% of total group). The incidence of H. pylori infection in the patients with gastrointestinal manifestations of allergies was 27.5% of the group. Among the gastrointestinal manifestations of allergies, inflammatory diseases of the esophagus, stomach, and intestines, e.g., gastroesophageal reflux, gastritis, and duodenitis were most common. In the group of HP-infected children the incompetence of cardia was more often, being statistically significant. In the group of HP-noninfected children, esophagitis, bulbitis, erosive lesions of the stomach and duodenum were more common, however, the difference did not reach statistical significance. The spectrum of sensitization in the patients with gastrointestinal manifestations of allergies showed some features depending on the presence of HP infection. E.g., sensitization to birch and meadow grass mixture was found to be significantly more often in the group of HP-infected children, Among the HP-noninfected children, sensitization to house dust mite, cat wool, and dog wool was more often detected. Hence, when examining children with gastrointestinal manifestations of allergies it is necessary to exclude the presence of H. pylori infection, which can modify the course of a genuine allergic pathology.