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Helicobacter pylori and iron deficiency anemia

IHN logo ROME, ITALY. Recent studies have shown an association between Helicobacter pylori infection and iron deficiency. Now medical doctors at the University La Sapienza report that iron deficiency anemia in patients with H. pylori-associated gastritis can be cured by eradicating the bacteria. The experiment involved 30 patients (26 women and 4 men) who had iron deficiency anemia of long standing. All patients had undergone a thorough gastrointestinal evaluation and the only abnormality discovered was the presence of H. pylori- associated gastritis (inflammation of the stomach lining). All patients were treated for two weeks with 40 mg/day of omeprazole (Losec) and 1000 mg/day of amoxicillin; for the first week they were also given 250 mg of metronidazole three times daily after meals. Study participants also stopped taking all iron supplements. The patients underwent a clinical examination three, six, and twelve months after the completion of the eradication regimen. At the three-month check-up all patients reported the disappearance of anemia-related symptoms such as fatigue, pallor, and decreased exercise capacity. An endoscopic evaluation at six months showed that H. pylori had been eradicated in 89.3 per cent of the patients and that 75 per cent of them had completely recovered from anemia; this recovery rate rose to 91.7 per cent after 12 months. Average ferritin levels increased by more than 300 per cent over the 12-month follow-up period from 5.7 micrograms/L to 24.1 micrograms/L; this despite the discontinuation of iron supplements. The researchers urge further studies with larger groups of patients, but nevertheless conclude that eradication of H. pylori in iron deficient anemia patients with H. pylori-associated gastritis can lead to a complete recovery and eliminate the need for iron supplements.
Annibale, Bruno, et al. Reversal of iron deficiency anemia after Helicobacter pylori eradication in patients with asymptomatic gastritis. Annals of Internal Medicine, Vol. 131, November 2, 1999, pp. 668-72

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