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Helicobacter pylori And Duodenal Ulcer: Systematic Review Of Controversies In Causation

Authors Ahmed S, Belayneh YM

Received 22 August 2019

Accepted for publication 10 October 2019

Published 18 November 2019 Volume 2019:12 Pages 441—447

DOI https://doi.org/10.2147/CEG.S228203

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Anastasios Koulaouzidis


Solomon Ahmed, Yaschilal Muche Belayneh

Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia

Correspondence: Yaschilal Muche Belayneh
Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, P. O. Box: 1145, Dessie, Ethiopia
Tel +251918092466
Email yaschilal.muche19@gmail.com

Background: There are controversies on the causal role of H. pylori in duodenal ulceration. Helicobacter pylori are curved gram-negative microaerophilic bacteria found at the layer of gastric mucous or adherent to the epithelial lining of the stomach. It’s a public health significance bacteria starting from discovery, and the prevalence and severity of the infection varies considerably among populations. H. pylori are a risk for various diseases, while the extent of host response like gastric inflammation and the amount of acid secretion by parietal cells affects the outcome of infection.
Method: Relevant literature were searched from databases such as Google Scholar, PubMed, Hinari, Web of Science, Scopus, and Science Direct.
Result: The review evidence supports a strong causal relation between H. pylori infection and duodenal ulcer, as patients are more likely to be infected by virulent strains which later cause duodenal ulceration. Thus, eradication of H. pylori infection decreases the incidence of duodenal ulcers, and prevents its recurrence by reducing both basal gastrin release and acid secretion without affecting parietal cell sensitivity. On the other hand, some studies show that H. pylori infection is not associated with the development of duodenal ulcers and such a lack of association revealed that duodenal ulceration has different pathogenesis.
Conclusion: Despite controversies observed in the causal role of H. pylori to duodenal ulceration by various studies, Hill criteria of causation proved the presence of a causal relation between H. pylori infection and duodenal ulcers. Other factors are also responsible for the development of duodenal ulcers and such factors are responsible for the differences in the prevalence of the diseases.

Keywords: H. Pylori, duodenal ulcer, causation, controversies

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