Is Helicobacter pylori Infection Associated with Perforated Gastro-Duodenal Ulcer?

BACKGROUND About 95% of the patients suffering from duodenal ulcer and 70-80% of the gastric ulcer patients are found to be Helicobacter pylori (H. pylori) positive. Although the role of H. pylori is well known in peptic ulcer disease aetiology, its role in perforated peptic ulcer is not well established. There are conflicting results in the literature regarding its association, with some studies showing high prevalence of H. pylori infection in gastro-duodenal perforation patients and also its eradication prevented the relapse of ulcer while others showing low or lack of association, suggesting a different pathogenesis for perforated peptic ulcer. METHODS Group-I patients were operated for gastro-duodenal perforation and group-II patients were with the upper gastrointestinal endoscopic diagnosis of peptic ulcer disease. The mucosal biopsy samples taken from antrum from both the groups were tested with rapid urease test and histopathological examination to detect H. pylori. RESULTS The prevalence of H. pylori infection was significantly less in patients with perforated gastro-duodenal ulcer than with peptic ulcer disease (p-value-0.026; OR -0.31). CONCLUSIONS Through this study it was found that alcohol intake and smoking were significant risk factors associated with perforation of gastro-duodenal ulcer whereas NSAIDs use was not significantly associated. H. pylori infection was not significantly associated with perforated gastro-duodenal ulcer suggesting that some other factors were involved in perforation.