الفهرس 
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Abstract
Conflicting results have been reported by numerous epidemiological studies investigating
the association between Helicobacter pylori infection and inflammatory bowel disease (IBD). We
aimed in this study to assess the possible association between H. pylori infection and IBD and its
effects on disease progression.
Design: Prospective observational study
Setting: Specialized IBD care clinics at Alexandria University Student Hospital in northern Egypt,
between March and June 2019.
Participants: A total of 182 patients with IBD.
Analysis and outcome measures: IBD participants were screened for H. pylori infection and
clinically evaluated at the initial visit and bimonthly for 3 months to record any potential
improvement/flare of the IBD condition.
Results: Overall, 90 (49.5%) patients with IBD had evidence of H. pylori infection. The course of
IBD did not significantly differ in association with H. pylori infection or IBD treatment strategy. Cox
regression analysis revealed that patients aged 20–35 years (OR, 95% CI= 6.20 [1.74–22.12]) and 35–
55 years (OR, 95% CI = 557.9, [17.4–17922.8]), high socioeconomic status (OR 95% CI = 2.9 [1.11–
7.8]), daily consumption of fiber-rich food (OR, 95% CI = 5.1 [1.32–19.5]), occasional consumption
of snacks between meals (OR, 95% CI = 2.8 [2.5–70.5]), and eating four meals per day (OR, 95% CI
= 13.3 (1.0–7.7]) predicted IBD flare. In contrast, eating fruits and vegetables was strongly protective
(OR, 95% CI = 0.001 (0.0002–0.02]). The probabilities of improvement of IBD symptoms after 12
weeks of follow-up were comparable, considering H. pylori infection status (0.793, H. pylori-negative
vs. 0.778, H. pylori-positive) or IBD treatment option (0.811, conventional therapy vs. 0.750,
biological therapy).
Conclusion: The association between IBD and H. pylori infection is unresolved and must be further
evaluated in the context of specific environmental exposures that influence the development or relapse
of IBD.
Keywords: Inflammatory Bowel Disease; Crohn’s disease; Ulcerative colitis; Helicobacter pylori.