Helicobacter pylori infection and gastric function in primary autonomic neuropathy

Abstract

Helicobacter pylori (Hp) infection in diabetic patients has been related to impaired gastric clearance of bacteria due to autonomic neuropathy. Gastrointestinal dysfunction has been described in primary autonomic failure (AF). The aim of the study was to evaluate, for the first time, the presence of Hp infection and gastric function in patients with primary AF Twelve patients with primary AF (aged 58-78), 31 healthy controls (aged 48-75) and 31 patients affected by type 2 diabetes (aged 46-75) were studied. A 13C-urea breath test was performed to assess the presence of Hp infection. To evaluate gastric function, AF patients underwent two non-invasive tests: 1) 13C-octanoic acid breath test (OBT) to evaluate gastric emptying, and 2) electrogastrogram (EGG) to evaluate gastric electrical activity. Hp infection was found in 100% of AF patients, in 48% of controls and in 71% of diabetic patients (p = 0.02 between groups). Electrical or mechanical gastric function was altered in 50% of AF patients. In particular, 1) after OBT, half-time gastric emptying was delayed in 6 out of 12 patients, and 2) EGG showed the presence of gastric dysrhythmias in 6 out of 12 patients. In conclusion, Hp infection was detected in all AF patients studied; as previously demonstrated in diabetes, such a finding might be related to autonomic neuropathy causing mechanical or electrical gastric dysfunction. Hp detection might be important for the gastrointestinal and extradigestive complications of such infection.

Impact of Cytotoxin-Associated Gene Product-A Positive <i>Helicobacter Pylori</i> Strains on Micro-albuminuria in Type 2 Diabetes

“…This is in agreement with previous studies reported by Candelli et al [10], Anastasios et al [7], Demir et al [8] Xia et al [9], and Ko et al [11]. However, other studies reported a higher prevalence of H. pylori infection in type 2 diabetic patients in comparison to non diabetic subjects [12][13][14][15]. This discrepancy between results may be attributable to differences in sensitivity of methods used to detect infection or to differences in selection of control groups and sample sizes.…”

“…Community based surveys gave conflicting results about the prevalence of gastro-intestinal (GI) tract symptoms in persons with or without DM [5,6]. Some studies reported no difference in H. pylori infection rates between diabetic patients and controls [7][8][9][10][11], while other studies reported a higher rate of H. pylori infection in diabetic patients [12][13][14][15].…”

Vascular Risks and Complications in Diabetes Mellitus: The Role of Helicobacter Pylori Infection

“…These contradictory results about the relation of H pylori infection to DM were attributed to the absence or presence of microangiopathy in gastric mucosa, which may create an unfavorable environment for establishment or survival of H pylori. 22 In this study, male patients were found to be more vulnerable to infection by H pylori than female patients. 25 In agreement with many studies, we found higher risk for H pylori infection among rural residents compared with urban.…”

“…Many authors suggested that delayed gastric clearance could be attributed to bacterial colonization or overgrowth in the gastrointestinal tract as a result of autonomic neuropathy, which is common in DM (gastroparesis diabeticorum). 8,22 Data are expressed as mean (SD). In contrast, some studies reported a lower prevalence of H pylori in a diabetic than in a healthy population.…”

Dysautonomia

“…Autonomic failure patients should be treated as if they have a full stomach. Gastroparesis in autonomic failure can predispose to aspiration upon induction of anesthesia 44;45 .Constipation, due to decreased gastrointestinal motility, and fecal incontinence are common in patients with autonomic failure, this may result in inadequate bowel preparation for colon surgery. Use of narcotics postoperatively may exacerbate the already sluggish intestinal motility and result in intestinal pseudo-obstruction and toxic megacolon.…”