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30-04-2012 | Infectious disease | Article

H. pylori and nasal polyposis not linked in absence of GERD


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MedWire News: Helicobacter pylori is not associated with nasal polyposis in patients without symptoms of gastroesophageal reflux disease (GERD), report researchers.

"Our study showed that H. pylori can be considered as an accidental finding, rather than an etiological factor, in patients with nasal polyposis," say Rahmatollah Banan (Amiralmomenin Hospital, Rasht, Iran) and colleagues.

There are contradictions among studies about the relationship between H. pylori and nasal polyposis, says the team, and "in the previous studies the researchers did not use highly sensitive and gold standard methods for H. pylori detection."

Banan et al therefore decided to conduct a cross-sectional analysis to test for H. pylori in patients with nasal polyposis using three methods: the rapid urease test, polymerase chain reaction (PCR), and culture.

The researchers tested biopsies from 25 patients with sinonasal polyposis who did not have peptic ulcer disease or GERD symptoms and who had been referred for endoscopic sinus surgery. They also analyzed specimens from 25 control individuals who did not have nasal polyposis or peptic ulcer disease, but who underwent surgery because of concha bollusa.

The researchers report that neither the rapid urease test nor the PCR examination showed any contamination of specimens with H. pylori among the patients with nasal polyps. In addition, all the cultures showed no growth of H. pylori among this patient group.

The three tests were also negative for H. pylori in all individuals from the control group.

Banan and team say that in a previous study, the nasal polyp specimens from six of 23 patients with chronic rhinosinositis were positive for H. pylori when the rapid urease test was performed. However, all six of the H. pylori-positive patients also had GERD, they note.

"It is assumed that H. pylori can reside primarily in the sinuses or nasal cavity, or it can be transmitted by gastroesophageal reflux to the nasal cavity, sinuses, or even the middle ears," say the researchers.

"Perhaps the latter is more probable, because in our study… we excluded those cases with signs and symptoms or history of GERD or peptic ulcer disease and found no correlation between H. pylori and nasal polyposis."

"The outcome of this study, therefore, can be generalized to those patients with nasal polyposis and no signs and symptoms of GERD," writes the authors in the European Archives of Oto-Rhino-Laryngology.

"Further studies are needed to find the other related causes of nasal polyposis," they conclude.

By Sally Robertson

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