Cystic fibrosis, gastroduodenal inflammation, duodenal ulcer, and H. pylori infection: The “cystic fibrosis paradox” revisited

• Published in: Journal of cystic fibrosis Vol. 12; no. 4; pp. 377 - 383
• Main Authors: Ramos, Ana Flávia Passos, de Fuccio, Marcelo Bicalho, Moretzsohn, Luciana Dias, Barbosa, Alfredo José Afonso, Passos, Maria do Carmo Friche, Carvalho, Rhaissa Said, Coelho, Luiz Gonzaga Vaz
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2013
• Subjects: Adolescent; Adult; Aged; Cystic Fibrosis - complications; Cystic fibrosis and duodenal ulcer; Cystic fibrosis and gastritis; Cystic fibrosis and Helicobacter pylori infection; Duodenal Ulcer - etiology; Duodenal Ulcer - pathology; Duodenitis - etiology; Duodenitis - pathology; Endoscopy, Gastrointestinal; Female; Gastritis - etiology; Gastritis - pathology; Helicobacter Infections - complications; Helicobacter Infections - epidemiology; Helicobacter pylori; Humans; Male; Middle Aged; Prevalence; Pulmonary/Respiratory; Young Adult; Cystic fibrosis and Helicobacter pylori infection; Cystic fibrosis and duodenal ulcer; Cystic fibrosis and gastritis
• ISSN: 1569-1993; 1873-5010
• DOI: 10.1016/j.jcf.2012.11.001

Abstract Background In cystic fibrosis (CF) patients a duodenal impaired bicarbonate secretion and unbuffered gastric acid are always described and the development of duodenal ulceration is uncommon (CF paradox). Helicobacter pylori (HP) infection is the main cause for duodenal ulceration and its prevalence in CF patients is controversial. Aim The objective of this study is to evaluate HP prevalence, gastric histology, and duodenal ulceration in adult FC patients. Methods 32 adult CF patients were submitted to13 C-urea breath test and serum immunoblotting test for HP diagnosis. Among them, 20 patients were submitted to endoscopy. Results 19/32 (68%) patients showed positive serology. Endoscopy showed erosive duodenitis (15%), and duodenal ulcer scar in 10%. On duodenal histology, 94.5%, showed active inflammation and 66.7% gastric metaplasia. Conclusion HP infection prevalence in adult CF patients was similar to that of general Brazilian population. CF patients have all the duodenal spectrum of alterations, including duodenal ulcer. CF paradox may not exist.