H PYLORI INFECTION AND ASSOCIATED VITAMIN B12 DEFICIENCY

Abstract

Helicobacter pylori (H. pylori) infection is one of the most common gastrointestinal infections worldwide, and it has been implicated in the development of vitamin B12 deficiency. Chronic H. pylori infection leads to gastric mucosal inflammation, which may impair the absorption of vitamin B12. Early identification and treatment of H. pylori infection may prevent the clinical consequences of vitamin B12 deficiency, such as anemia and neurological disorders. Objective: To evaluate the incidence and association factors of vitamin B12 deficiency in patients who are suffering from H pylori infection. Study Design: Cross Sectional Study Duration of Study: Department of Internal Medicine, Islamabad Medical Complex from August 2021 to May 2022. Methods: All patients having Helicobacter pylori serology, Urea breath test or H pylori stool antigen positive were included. A detailed history and clinical evaluation of patients was done. All patients were provided standard triple regimen fr H-pylori eradication. Demographic details, symptoms, blood complete picture including the mean corpuscular volume (MCV), hemoglobin and Vitamin B12 level were evaluated. B-12 levels less than 190 pg/ml were considered low and MCV between 80-100 fl was considered normal. Chi-square as applied to see the association. Results: A total of 200 cases participated in the study. There were 102(51%) females and 98 (49%) were male. The mean age of the patients was 41.77+ 12.67 years. Among the participants, most common symptom was dyspepsia present in 61 (30.5%). A total of 149 (74.5%) patients were diagnosed through H pylori serology. Although 54.5% of patient were deficient in B-12 levels yet only 34 (17%) had macrocytosis and 14 (7%) showed microcytosis. Anemia was present in 89 (44.5%) showing mixed picture. So, B-12 deficiency was sub-clinical. Patients with anemia responded better to standard treatment (p value=0.025).Conclusion: The incidence of vitamin B 12 deficiency is high among H pylori infected cases. Prompt treatment of H pylori gastritis may help prevent clinical manifestation of B 12 deficiency.