Effect of anti-Helicobacter pylori therapy on outcome of iron-deficiency anemia: a randomized, controlled study.

BACKGROUND Helicobacter pylori infection may play a role in iron-deficiency anemia. METHODS In 52 patients with iron-deficiency anemia, H. pylori status was determined using rapid urease test and histology. H. pylori -positive patients were randomly assigned to receive anti- H. pylori treatment either immediately (Group I) or after a delay of one month (Group II); in addition, all patients received oral ferrous sulfate for three months. Patients testing negative for H. pylori (Group III) received only oral ferrous sulfate. Hematological parameters were tested every month. RESULTS Of 52 patients, 32 (61.5%) had H. pylori infection. At the end of one month, median increase in hemoglobin level was lower in Group II than in Groups I and III (1.1 g/dL vs. 3.6 g/dL and 1.9 g/dL, respectively; p=0.025), as were that in serum iron (19 mcg/dL vs. 55.5 mcg/dL and 41 mcg/dL; p=0.019). During the second month, after H. pylori infection in Group II had been treated, median increase in hemoglobin in this group was comparable to those in Groups I and III (3.7 g/dL vs. 2.5 g/dL and 2.5 g/dL. CONCLUSION In patients with iron-deficiency anemia, presence of H. pylori infection is associated with a poorer response to oral iron therapy, which improves with treatment for H. pylori infection.