Helicobacter pylori (Hp) infection and upper gastrointestinal mucosal changes in Crohn's disease patients from the population with high prevalence of Hp

Abstract

Background

Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) that may affect any segment of the gastrointestinal tract from the mouth to the anus. Helicobacter pylori (Hp) infection and upper gastrointestinal mucosal changes in Crohn's disease patients from the population with high prevalence of Hp disease pathogenesis involves genes and environment as cofactors in inducing autoimmunity; particularly the interactions between enteric pathogens and immunity are being studied. While the lower gastrointestinal (GI) tract has been well studied in CD patients, the upper GI tract has attracted less attention. The prevalence of upper GI involvement of CD was considered to be relatively low (0.5– 16.0%) [1-4], but not far ago prospective researches have revealed that a considerable percentage of CD patients (24–56%) exhibit upper GI lesions [5-8]. Gastroscopy with biopsies is considered the gold standard in the diagnosis of gastroduodenale CD. The gastric antrum and duodenal bulb are most frequently involved, while proximal gastric and distal duodenal involvement are uncommon [9-12]. Endoscopic findings in CD may include aphthous ulceration, erosions, patchy erythematous mucosa, thickened folds, fistulae and bamboo jointlike appearances .