bismuth-tripotassium-dicitrate and Anemia--Iron-Deficiency

In the present study, we investigated the prevalence of anaemia and Fe deficiency anaemia (IDA) and explored the relationship between Helicobacter pylori infection and IDA in adolescent girls. A total of 1037 adolescent girls from Suihua, China were enrolled. Hb, serum ferritin (SF), serum transferrin receptor (sTfR) and serum IgG antibodies to H. pylori were measured. Participants with IDA and co-existing H. pylori infection (n 80) who had an intake of >25 mg/d of Fe were assigned randomly to the intervention and control groups. Patients in the intervention group were administered a 12-week course of oral EDTA-Na-Fe (60 mg Fe/dose, three times a week) and a 2-week course of colloidal bismuth subcitrate, amoxicillin and metronidazole. Subjects in the control group were administered EDTA-Na-Fe alone. Hb, SF and sTfR were reassessed 3 months after the 12-week regimen ended. Prevalence of anaemia, Fe deficiency (defined as SF < 12·0 μg/l), IDA and H. pylori infection in the population of 1037 was 19.5, 40.4, 17.1 and 31.2 %, respectively. The prevalence of H. pylori infection in the IDA group was 46.9 %, while the non-anaemic group had 28.1 % prevalence. A significant increase in Hb and SF and a decrease in sTfR value were found in the intervention group and the H. pylori-negative group. Findings suggest that IDA is still one of the prominent problems in adolescent girls. There is an association between H. pylori infection and IDA. Treatment of H. pylori infection is associated with a more rapid response to oral Fe therapy.

Topics: Adolescent; Amoxicillin; Anemia, Iron-Deficiency; Anti-Bacterial Agents; Anti-Ulcer Agents; Antibodies, Bacterial; Child; China; Dietary Supplements; Drug Therapy, Combination; Edetic Acid; Female; Ferric Compounds; Follow-Up Studies; Helicobacter Infections; Helicobacter pylori; Humans; Mass Screening; Metronidazole; Organometallic Compounds; Prevalence; Suburban Health; Urban Health

To elucidate the influences of H pylori infection on oral iron treatment for iron deficiency anemia (IDA).. A total of 86 patients were divided into two groups: group A, receiving ferrous succinate combined with triple therapy for H pylori eradication, and group B (control), treated with ferrous succinate only. During treatment of IDA, dynamic changes in hemoglobin (Hb) level, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), serum iron (SI), and serum ferritin (SF) were compared between the groups.. Hb was slightly higher in group A at d 14 after the start of triple therapy for H pylori eradication (P > 0.05). After the therapy, the increase of Hb in group A became significantly faster than that in group B (P < 0.05). At d 56, the mean Hb in group A returned to the normal level, however, in group B, it was lower than that in group A (P < 0.05) although it had also increased compared with that before oral iron treatment. The MCV and MCH in group A recovered to the normal level, and were much higher than those in group B (P < 0.05) at d 21. In Group B, the MCV and MCH remained at lower than normal levels until d 42 after the start of therapy. And then, they reached a plateau in both groups and the differences disappeared (P > 0.05). The SF in group A was higher than that in group B (P < 0.05) 28 d after the treatment and its improvement was quicker in group A (P < 0.05) , and the difference between the two groups was even more significant (P < 0.01) at d 56. The SI in group A was higher than that in group B (P < 0.05) at d 14 and this persisted until d 56 when the follow-up of this research was finished.. Treatment of H pylori can enhance the efficacy of ferrous succinate therapy in IDA patients with H pylori-positive chronic gastritis.

Topics: Adolescent; Adult; Aged; Amoxicillin; Anemia, Iron-Deficiency; Anti-Infective Agents; Chronic Disease; Drug Therapy, Combination; Erythrocyte Indices; Female; Ferritins; Ferrous Compounds; Gastritis; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Iron; Male; Metronidazole; Middle Aged; Organometallic Compounds; Risk Factors

Both iron deficiency anaemia and Helicobacter pylori infection are rare in developed countries. A possible connection has been suggested between these two diseases and our aim was to define the clinical picture and to study the effect of bacterial eradication in H. pylori colonized children with severe anaemia.. Eight children with iron deficiency anaemia refractory to iron supplementation were examined with gastroscopy because of suspicion of H. pylori infection. Anaemia was treated with oral ferrous sulphate. Two patients needed blood transfusions. Eradication therapy was given either with combination of colloidal bismuth subcitrate and metronidazole or with omeprazole, clarithromycin and amoxycillin. Eradication was confirmed by urea breath test 4 weeks post-treatment.. H. pylori infection was confirmed histologically and microbiologically in all children, who also presented with chronic, active gastritis. Bacteria were successfully eradicated in 7/8 patients. Correction of haemoglobin values was observed post-treatment, iron stores still being deficient at control in 4/8 children.. Our results suggest that H. pylori might have a role in causing iron deficiency anaemia in school-age children. Screening for H. pylori should be extended to cover those patients with other clinical manifestations than symptoms from gastrointestinal tract.

Topics: Adolescent; Amoxicillin; Anemia, Iron-Deficiency; Anti-Bacterial Agents; Anti-Ulcer Agents; Breath Tests; Child; Chronic Disease; Clarithromycin; Drug Therapy, Combination; Gastritis; Gastroscopy; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Metronidazole; Omeprazole; Organometallic Compounds; Proton Pump Inhibitors; Urea

A few cases relating H. pylori infection to iron-deficiency anemia have been described recently. We investigated the role of H. pylori infection in iron-deficiency anemia in preadolescent children and adolescents.. We conducted a double-blind, placebo-controlled therapeutic trial in 43 subjects (mean age, 15.4 years) with iron-deficiency anemia. Endoscopy was performed, and biopsy specimens were examined by urease test and histological analysis. Twenty-two of 25 H. pylori-positive patients were assigned randomly to three groups. Group A patients were given oral ferrous sulfate and a 2-week course of bismuth subcitrate, amoxicillin, and metronidazole. Group B patients were given placebo for iron and a 2-week course of triple therapy. Group C patients were given oral ferrous sulfate and a 2-week course of placebo. Iron status was reassessed 4 weeks and 8 weeks after the 2-week regimen ended.. Of the 43 subjects with iron-deficiency anemia, 25 (58.1%) had H. pylori in the antrum. Group A and B subjects, who received eradication therapy, showed a significant increase in hemoglobin level as compared with group C subjects at 8 weeks after therapy (p = .0086).. Treatment of H. pylori infection was associated with more rapid response to oral iron therapy as compared with the use of iron therapy alone. Such treatment also led to enhanced iron absorption even in those subjects who did not receive oral iron therapy.

Topics: Adolescent; Amoxicillin; Anemia, Iron-Deficiency; Anti-Bacterial Agents; Anti-Ulcer Agents; Bismuth; Child; Double-Blind Method; Drug Therapy, Combination; Female; Ferrous Compounds; Helicobacter Infections; Helicobacter pylori; Hemoglobins; Humans; Intestinal Absorption; Male; Metronidazole; Nutritional Status; Organometallic Compounds; Placebos; Pyloric Antrum