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Inverse relationship between alcohol consumption and active Helicobacter pylori infection: The Bristol Helicobacter Project
Abstract
The aim of this study was to examine whether smoking or consumption of alcohol or coffee is associated with active Helicobacter pylori (H. pylori) infection.
This was a cross-sectional population study conducted as part of a randomized controlled trial of H. pylori infection eradication in southwest England. A total of 10,537 subjects, recruited from seven general practices, underwent 13C-urea breath testing for active infection with H. pylori and provided data on smoking, usual weekly consumption of alcohol, and daily intake of coffee.
Smoking or coffee consumption were not related to active H. pylori infection. Total alcohol consumption was associated with a small, but not statistically significant, decrease in the odds of infection. After adjustment for age, sex, ethnic status, childhood and adult social class, smoking, coffee consumption, and intake of alcoholic beverages other than wine, subjects drinking 3-6 units of wine/wk had an 11% lower risk of H. pylori infection compared with those who took no wine: OR = 0.89, 95% CI = 0.80-0.99. Higher wine consumption was associated with a further 6% reduction in the risk of infection: OR = 0.83, 95% CI = 0.64-1.07. Intake of 3-6 units of beer (but no greater intake) was associated with a similar reduction in the risk of infection when compared to no beer intake (OR = 0.83, 95% CI = 0.75-0.91).
This study indicates that modest consumption of wine and beer (approximately 7 units/wk) protects against H. pylori infection, presumably by facilitating eradication of the organism.
... Furthermore, frequent consumption of alcohol (>once/week) showed no significant association but less frequent consumption (<once/week) was protective [21]. In Germany, an inverse relationship was also documented between amount of alcohol consumption and H. pylori infection [38,39] as moderate amount of alcohol consumption in the form of wine and beer protects against H. pylori infection [40]. However, the current study is in opposition to previously mentioned studies [19,21,22,[38][39][40] as frequent consumption of alcohol (>once/week) was significantly associated with feco-prevalence of H. pylori (p = 0.001). ...
... In Germany, an inverse relationship was also documented between amount of alcohol consumption and H. pylori infection [38,39] as moderate amount of alcohol consumption in the form of wine and beer protects against H. pylori infection [40]. However, the current study is in opposition to previously mentioned studies [19,21,22,[38][39][40] as frequent consumption of alcohol (>once/week) was significantly associated with feco-prevalence of H. pylori (p = 0.001). But our result is in line with previous report as large amount of alcohol consumption is positively associated with active H. pylori infection [41]. ...
... H. pylori stool antigen detection was not statistically associated with coffee consumption which is similar to previous reports from Ethiopia [22] and England [40], but differs from Germany where coffee consumption showed a positive dose response relation with active H. pylori infection [38]. This contradictory result might be due to variation in type, frequency as well as amount of daily consumed coffee which needs further study. ...
Background:
Helicobacter pylori (H. pylori) infection is the most common chronic bacterial infection in the world. It can result in various upper gastroduodenal diseases. The prevalence varies among countries, population groups within the same country and testing methods. The aim of the study was to determine feco-prevalence and risk factors of H.pylori infection among symptomatic patients in Amhara region, Northeast Ethiopia.
Methods:
A cross sectional study was conducted in a total of 342 new consecutive outpatients with upper abdominal complaints at Dessie Referral Hospital from May to July, 2016. A structured questionnaire was used to collect the socio-demographic, lifestyle and environmental data. Stool samples were used to detect H. pylori specific antigen. Blood samples were assessed for anti-H. pylori IgG and ABO blood types. SPSS version 20.0 statistical software package was used for data analysis. Chi-square test and logistic regression were used in the analysis and P-value ≤0.05 was considered as statistically significant.
Results:
H. pylori stool antigen and serum anti-H.pylori IgG detection rate was 30.4 and 60.5% respectively with kappa measure of agreement of 0.271. Antigen detection was significantly associated with family size (> 3) [AOR = 1.83, 95% CI: 1.10-3.05, p = 0.02], more persons (> 3) sharing the same bed room in the household [AOR = 2.91, 95% CI: 1.39-6.11, p = 0.005], alcohol consumption (> once a week) [AOR = 2.70, 95% CI: 1.49-4.89, p = 0.001] and individuals' blood type: group O [AOR = 8.93, 95%CI: 1.79-44.48, p = 0.008] and group A [AOR = 5.53, 95%CI: 1.08-28.36, p = 0.040]. Gender, age, marital status, occupation, educational level, residence, smoking as well as coffee, tea, fruits and vegetables consumption were not statistically associated with H. pylori antigen detection (p > 0.05).
Conclusion:
The overall H. pylori stool antigen and anti-H. pylori IgG detection rate was 30.4 and 60.5%, respectively. The test agreement was not strongly convincing and needs further evaluation. Alcohol consumption, overcrowding and ABO blood group were significantly associated with H. pylori antigen detection.
... To our knowledge, this variable has not previously been used as a socio-economic status indicator in any study related with H.pylori infection. Some previous studies have presented an inverse association between H. pylori infection and family income as a socio-economic status indicator [29,38,42,43,[52][53][54]. In TURHEP, the lower the income of the subjects, the higher the infection, but only in a univariate analysis. ...
... In TURHEP, regular alcohol consumption was found to be a protective factor except for the females model. Similar results have also been presented in some earlier studies [53][54][55][56]. In a EUROGAST Study, a univariate analysis showed that alcohol consumption was associated with a reduced prevalence of H.pylori, but this effect disappeared completely after adjustment in the multivariate analysis [34]. ...
Helicobacter pylori is an important global pathogen infecting approximately 50% of the world's population. This study was undertaken in order to estimate the prevalence rate of Helicobacter pylori infections among adults living in Turkey and to investigate the associated risk factors.
This study was a nationally representative cross sectional survey, using weighted multistage stratified cluster sampling. All individuals aged >=18 years in the selected households were invited to participate in the survey. Ninety two percent (n = 2382) of the households in 55 cities participated; 4622 individuals from these households were tested with the 13C-Urea breath test. Helicobacter pylori prevalence and associated factors were analysed by the t test, chi square and multiple logistic regression with SPSS11.0.
The weighted overall prevalence was 82.5% (95% CI: 81.0-84.2) and was higher in men. It was lowest in the South which has the major fruit growing areas of the country. The factors included in the final model were sex, age, education, marital status, type of insurance (social security), residential region, alcohol use, smoking, drinking water source. While education was the only significant factor for women, residential region, housing tenure, smoking and alcohol use were significant for men in models by sex.
In Turkey, Helicobacter pylori prevalence was found to be very high. Individuals who were women, elderly adults, single, had a high educational level, were living in the fruit growing region, had social security from Emekli Sandigi, were drinking bottled water, non smokers and regular alcohol consumers, were under less risk of Helicobacter pylori infection than others.
... El potencial patogénico de las cepas circulantes de Hp ha sido considerado como un factor decisivo en la evolución de la infección y en el desarrollo de cáncer gástrico 9 , así como relacionado con factores condicionados a circunstancias geográficas y raciales 10 . Algunos autores en Reino Unido manifestaron que los factores del estilo de vida durante la adultez, como el tabaquismo y el alcohol, podrían influir en una erradicación espontánea del Hp 11 . Existen informes que indican que el alcohol tiene una acción antibacteriana, dependiendo de su concentración y cantidad de ingesta, disminuyendo el riesgo de infección mediante la inducción de adaptación citoprotección como resultado de su uso a largo plazo, mientras que otros informan de que no hay diferencia de prevalencia entre los alcohólicos y la población normal 12 . ...
... Estos resultados difieren de otros 22,24,28 que no encontraron ninguna asociación entre consumo de alcohol y presencia de infección por Hp. Contrariamente, otros investigadores 11,19,[25][26][27] sugirieron un efecto protector del consumo de alcohol frente a la infección activa por Hp. ...
There is a high prevalence worldwide of Helicobacter pylori (Hp) infection associated with gastritis and extends to gastric cancer. Reports have suggested that alcohol has antibacterial action and that its concentration and the amount consumed reduce the risk for Hp infection. In contrast, different studies suggest that tobacco and coffee consumption are risk factors for Hp infection, but their results are controversial.
To compare the frequency of alcohol consumption in patients infected by Hp with that of non-infected subjects and, as a secondary aim, to compare the association of smoking and coffee consumption with Hp infection.
A case-control study was conducted on Sinaloa State workers that underwent endoscopy and the Hp serology test. Cases were defined as patients with a positive Hp serology test or a positive biopsy with the rapid urease test. Alcohol consumption was categorized as: no consumption, low-risk, and at-risk. The sample included 269 subjects per group. Odds ratio (OR) and 95% confidence interval (CI) were calculated.
In both groups, the mean age of the subjects was 45.7 (SD: 9) years (P=.99), 139 of the subjects were women (51.7%) and 130 were men (48.3%); alcohol consumption was present in 108 (40.1%) and 85 (31.6%) of the cases and controls, respectively (P=.039), OR 1.45 (95%CI 1.019-2.069). The quantity of grams of alcohol in subjects with at-risk consumption was significant; However, there were no significant differences in relation to smoking and coffee consumption between the groups.
An association between alcohol consumption and HP infection was observed and no relation with HP infection was found with respect to smoking and coffee consumption.
... In addition to these in vitro results, there have been several crosssectional population studies on wine consumption and H. pylori infection eradication (Brenner, Rothenbacher, Bode, & Adler, 1999;Murray et al., 2002). Notwithstanding its cross-sectional design, these studies seem to support the hypothesis that wine consumption may reduce the odds of active infection with H. pylori. ...
... Some reports have described the indirect effect of a moderate wine intake has on the colonization of the human intestine by intestinal pathogens (Brenner, Rothenbacher, et al., 1999;Murray et al., 2002). For similar reasons, it has been proposed that this intake limits the infective capacity of intestinal pathogens, including H. pylori. ...
... A number of previous studies have reported that alcohol consumption has a protective effect or is not associated with H. pylori infection, probably due to increased gastric acid secretion and promotion of gastric emptying after alcohol intake, as alcohol has a powerful and direct antibacterial activity, thus potentially inhibiting the growth of H. pylori in the stomach. In addition, alcohol can promote gastric emptying and reduce the contact time between H. pylori and the gastric mucosa, which in turn can attenuate the rate of H. pylori infection [25,26]. In particular, red wine was found to prevent H. pylori-induced gastritis in a mouse model [27]. ...
Objective
The aim of this study was to understand the prevalence and potential risk factors of Helicobacter pylori (H. pylori) infection in Hainan Province, China.
Methods
We conducted this study in 21 health service stations in 5 cities of Hainan Province from August 2022 to April 2023. We selected the various participants based on a stratified whole-group sampling method. The 14C-UBT was used to analyze H. pylori infection in 3632 participants. We also analyzed the possible relationship between variables and H. pylori infection based on chi-square test and multifactorial logistic regression. The model was evaluated by performing a Hosmer–Lemeshow goodness-of-fit test and plotting receiver operating characteristic(ROC) curves.
Results
In total, the results of 3632 eligible participants (age: 14 to 93 years) were included in the analysis. The total prevalence of H. pylori infection in Hainan Province was approximately 38.7%. The prevalence of H. pylori infection was found to increase with age, stabilized in the age group of 45 to 64 years, but peaked in the age group of 65 years and older. In multifactorial analysis, the prevalence of H. pylori infection was positively associated with middle-aged adults (45–64 years), older adults (≥ 65 years), drinking, farmers, natural labor, routinely share utensils, have habit of frequent betel nut consumption, upper gastrointestinal symptoms, and family history of gastric cancer. The factors negatively associated with prevalence included family size ≤ 3, washing hands often before meals, frequent exercise, regular meals, and frequent consumption of fruits and vegetables. In addition, the Hosmer–Lemeshow test showed a good fit (χ² = 12.983, P = 0.112) and the area under ROC was 0.631 (95%CI: 0.613 ~ 0.649).
Conclusion
The prevalence of H. pylori infection in Hainan Province was observed to be moderate and closely related to age, local socioeconomic conditions, hygienic status and dietary habits.
... Another study has shown that moderate alcohol consumption may prevent H. pylori infection by facilitating the eradication of the bacteria [32]. Apart from that, some alcoholic beverages can stimulate gastric acid secretion, which may eliminate H. pylori by reducing the PH in the stomach [33]. ...
Background:
The aim of this current study was to identify the prevalence and risk factors of H. pylori infection in the low-risk area of gastric cancer in China, and evaluate the value of different gastric cancer screening methods.
Methods:
An epidemiological study was conducted in Yudu County, Jiangxi, China, and participants were followed up for 6 years. All participants completed a questionnaire, laboratory tests and endoscopy. Patients were divided into H. pylori positive and negative groups, and risk factors for H. pylori infection were identified using multivariate logistic regression analysis.
Results:
A total of 1962 residents were included, the prevalence of H. pylori infection was 33.8%. Multivariate analysis showed that annual income ≤20,000 yuan (OR: 1.44, 95% CI: 1.18-1.77, p < 0.001), loss of appetite (OR: 1.71, 95% CI: 1.29-2.26, p < 0.001), PG II >37.23 ng/mL (OR: 2.11, 95% CI: 1.50-2.97, p < 0.001), G-17 > 1.5 and ≤5.7 pmol/L (OR: 2.52, 95% CI: 1.93-3.30, p < 0.001), and G-17 > 5.7 pmol/L (OR: 1.96, 95% CI: 1.48-2.60, p < 0.001) were risk factors of H. pylori infection, while alcohol consumption (OR: 0.70, 95% CI: 0.54-0.91, p = 0.006) was a protective factor. According to the new gastric cancer screening method, the prevalence of low-grade intraepithelial neoplasia in the low-risk group, medium-risk group and high-risk group was 4.4%, 7.7% and 12.5% respectively (p < 0.001).
Conclusions:
In a low-risk area of gastric cancer in China, the infection rate of H. pylori is relatively low. Low income, loss of appetite, high PG II, and high G-17 were risk factors for H. pylori infection, while alcohol consumption was a protective factor. Moreover, the new gastric cancer screening method better predicted low-grade intraepithelial neoplasia than the ABC method and the new ABC method.
... Some studies, on the other hand, have reported the opposite, resulting in inconsistent results. 6 Our objective was to study the prevalence and association between H. pylori infection and alcohol or cigarette use among Iraqi patients who were submitted to gastrointestinal endoscopy. ...
Objective: The aim of this paper was to assess the prevalence and association between H. pylori
infection and alcohol, or cigarette use among Iraqi patients.
Methods: 115 individuals needed upper gastrointestinal endoscopies in total. Reverse transcription
polymerase chain reaction (RT-PCR), urea breath test, rapid urease test, CagA-IgG, and culture were
all used to confirm H. pylori infection. The information on alcohol consumption, smoking, sex, and
age was collected using a standard questionnaire.
Results: The gold standard test, RT-PCR, was used to detect H. pylori infection in 81 (70.4%) of
patients. H. pylori infection was not affected by age (OR: 0.976; CI: 95% (0.944-1.009; P > 0.05), sex
(OR: 1.26, 95% CI: 0.57–2.75; P > 0.05), or alcohol intake (OR: 0.293; CI: 95% (0.081-1.058; P > 0.05)
according to the binary logistic regression analysis. Additionally, there was a considerable inverse
association between smoking and H pylori infection (OR: 0.094; CI: 95% (0.025- 0.352; P < 0.05).
According to binary logistic regression analysis, both smoking (OR: 0.036; CI: 95% (0.007- 0.182;
P < 0.05) and alcohol intake (OR: 0.179; CI: 95% (0.041- 0.988; P < 0.05) were inversely and
significantly related with H. pylori illness whereas H. pylori infection did not alter with age
(OR: 1.001; CI 95% (0.959-1.044; P > 0.05) in the male subgroup.
Conclusions: According to the study, males who smoke and drink are more likely to have H. pylori
infections. Furthermore, there was no positive association between age and H. pylori infection
... Plant-derived natural products are best alternative for screening urease inhibition (Nabati et al., 2012;Ahmed et al., 2014). Previously, researchers (Murray et al., 2002;Lin et al., 2005) have indicated the potential of using plant extracts as antimicrobial agents in foods to inhibit H. pylori. Similarly, host antioxidant simulation is also related to enhanced H. pylori inhibition (Akyön and Hascelik, 1999). ...
... [7] By contrast, some studies have suggested that moderate alcohol can prevent and treat H. pylori infection by promoting the eradication of this organism. [47] There are some limitations in our study. First, the number of included studies was relatively small, and there was a great heterogeneity among studies. ...
Background and aims:
Helicobacter pylori infection is prevalent and recognized as a major cause of gastrointestinal diseases in the world. Previous studies on the prevalence of H. pylori infection in military personnel have shown some conflicting results. This study aimed to estimate the pooled prevalence of H. pylori infection and evaluate its risk factors in military personnel.
Methods:
The PubMed, EMBASE, and Cochrane Library databases were searched. We pooled the prevalence of H. pylori infection in military personnel using a random-effect model. Metaregression analysis was used to explore the sources of heterogeneity. Pooled proportion of H. pylori infection with 95% confidence interval (CI) was calculated.
Results:
Sixteen studies were included. Meta-analysis showed that the overall prevalence of H. pylori infection was 32% (95% CI = 31-33) in military personnel. There was a significant heterogeneity. Metaregression analysis showed that study region (P = 0.0004) and publication year (P = 0.023) were the potential sources of heterogeneity. In the subgroup analysis by study region, the highest prevalence was found in Asia (50.2%; 95% CI = 49-51.4). In the subgroup analysis by diagnostic methods for H. pylori, the highest prevalence was found when urea breath test was employed (47.9%; 95% CI = 46.5-49.3). The most common risk factor for H. pylori infection was familial aggregation, followed by living environment and age.
Conclusion:
H. pylori infection is common in military personnel. In future, we may require appropriate population screening for H. pylori infection by multiple diagnostic tests and increase the knowledge and awareness of the bacterial transmission among military personnel.
... Some studies have shown that alcohol has an antibacterial effect against H. pylori and the increase in acid secretion caused by alcohol has a bactericidal effect. While this may explain the inverse association between H. pylori infection and alcohol (37,38), others have found no significant association (39,40). The effects of alcohol on H. pylori infections require further research. ...
Background: Infectious diseases such as malaria, HIV/AIDS and tuberculosis have received tremendous attention globally but inspite of the widespread nature of infections caused by Helicobacter pylori, little attention has been paid to it especially in the developing countries. The objective of this study was to determine the prevalence of and factors associated with H. pylori infection among dyspeptic patients attending the University of Benin Teaching Hospital, Benin City, Nigeria. Methodology: This was a hospital based descriptive cross-sectional study of 354 treatment naive dyspeptic patients aged 18 to 44 years, recruited consecutively after obtaining institutional ethical approval and subjects’ informed consent. A pre-tested interviewer administered questionnaire was used to obtain subjects’ data. The stool antigen test was used to detect H. pylori infection. Results: The prevalence of H. pylori infection among the subject participants was 34.2% (38.4% in female, 24.0% in male, p=0.009). The age group < 20 years had the highest prevalence of 40%. Gender, occupation, increased body mass index, high number of household occupants, and rural dwelling, were significantly associated with H. pylori infection (p<0.05) and alcohol intake was inversely related to H. pylori infection (p<0.05). Conclusion: The prevalence of H. pylori infection in University of Benin Teaching Hospital is high and factors such as gender, obesity, occupation with risk of contact, low socio-economic status, and poor hygiene, may be responsible for this.Keywords: Dyspepsia, Helicobacter pylori, infection, stool antigen test
... pylori effects. The role of alcoholic beverages in defence against H. pylori infection has been reported widely (Murray et al. 2002;Kuepper-Nybelen et al. 2005;Gao et al. 2010). Daily moderate alcohol consumption appears to have an additive effect in the triple eradication therapy (Baena et al. 2002). ...
Aims:
To determine individual antibacterial and synergistic antibacterial effects of resveratrol and alcohol against H. pylori 26695 in vitro, and to elucidate the underlying mechanism of action of resveratrol against H. pylori.
Methods and results:
The MICs (minimum inhibitory concentration) and time-killing curve of resveratrol and alcohol were determined. Transcriptome analysis by RNA-sequencing was used to elucidate the underlying mechanism of action of resveratrol against H. pylori. Our results showed that the MICs of resveratrol and alcohol against H. pylori 26695 are about 64μg/ml and 4% (v/v) respectively. The synergy was found: resveratrol at concentration of 64μg/ml in combination with alcohol at concentration of 4% (v/v) showed> 10000-fold decrease in the mount of viable bacteria compared with resveratrol and alcohol used alone. Transcriptome analysis showed 152 genes were downregulated and 111 genes were upregulated in the presence of resveratrol. Genes involved in protein translation (17·1%), outer membrane proteins (OMPs) (9·9%), and transports (11·2%) comprise 38·2% of the downregulated genes. In comparison, genes involved in redox (13·5%), pathogenesis and motility (9·9%), iron homeostasis (4·5%) comprise 27·9% of the upregulated genes.
Conclusions:
The synergy of resveratrol and alcohol against H. pylori was found in this study. The underlying mechanism of action of resveratrol against H. pylori may be mainly attributed to its inhibitory effect on translation, OMPs, transports，ATP synthase and possible oxidative damage.
Significance and impact of this study:
Our study provides a global insight into the anti-H. pylori mechanism of resveratrol. Both resveratrol and alcohol can contribute to inhibition of ribosomes, changes of OMPs, and oxidative damage, which may be the explanations of synergistic effect against H. pylori elicited by resveratrol and alcohol.
... The prevalence of H. pylori infection has been previously reported to be negatively associated with the amount of alcohol consumption [27]. Similarly, Murray et al. found that alcoholic beverages has such effect by facilitating the eradication of H. pylori [28]. The mechanism of alcoholic beverages eradicating H. pylori might be the increased gastric acid Fig. 1 Age-specific prevalence of Helicobacter pylori infection diagnosed by a 13 C-urea breath test. ...
Background:
Only a paucity of large-scale perspective and cross-sectional studies on H. pylori infection in China have been published. The purpose of this study was to investigate the prevalence and risk factors for H. pylori infection among residents of Jidong community located in Hebei Province of China.
Methods:
A perspective, cross-sectional study was conducted in Jidong community. Questionnaires and 13C-urea breath test were performed, and 10-ml blood samples were obtained for laboratory tests.
Results:
Four thousand seven hundred ninety-six subjects were enrolled in this study, and 2506 (52.25%) were H. pylori positive. There was no difference in prevalence between both sexes (P = 0.5974). Age (P = 0.004) and education level (P = 0.0128) were significantly associated with H. pylori infection, and there were statistical trends in the prevalence across five age subgroups (χ2 test for trend = 23.5; P < 0.001) and education levels (χ2 test for trend = 19.50; P < 0.001). H. pylori infection was also associated with marital status (P = 0.0243), source of drinking water (P = 0.0433), frequency of eating raw garlic (P = 0.0310), alcohol drinking (P = 0.0207), knowledge about H. pylori transmission route (P = 0.0125) and related diseases (P = 0.0257). Age, alcohol drinking and knowledge about transmission route were found to be independent predictors of H. pylori infection.
Conclusions:
More than half of the population was infected with H. pylori in Jidong community. The socio-demographic profiles, socio-economic factors and lifestyle are worthy taking into consideration to prevent diseases associated with H. pylori infection. Understanding the prevalence and risk patterns for H. pylori infection in China will help in prioritizing public health efforts to better manage the H. pylori infection.
... It has demonstrated that alcohol consumption reduces the H. pylori infection rate and a moderate consumption may facilitate spontaneous elimination of H. pylori [29], [30]. Alcohol drinkers had 25% lower odds of being H. pyloripositive than non-drinkers [2]. ...
Introduction:
Few studies have investigated factors possibly related to the source of Helicobacter pylori infection in humans.
Materials and methods:
This was a retrospective study including a population of 201 H.pylori positive patients and 259 H. pylori negative subjects observed at a tertiary referral center in Apulia. The H. pylori status was assessed by urea breath test. Data on socio-demographic characteristics and the consumption of different foods and beverages in the last year were collected by a questionnaire.
Results:
No significant relationship was found between H. pylori infection and gender or age, type of employment, working in direct contact with the public, residence, level of education or exposure to pets. No association between H.pylori status and the consumption of fish, fruits, legumes, honey, spices, meats, milk and milk products including some typical product of our area was found. The same was true for the consumption of several kind of beverage including green tea and wine. Cigarette smoking and living in the same house with H.pylori positive relatives were significantly associated with H. pylori positivity. The intake of uncooked seafood (mussels and other molluscs) as well as some uncooked vegetables such as tomatos,pepper,and chicory,municipal water and the number of cups of coffee consumed per week correlated significantly with H. pylori status. The consumption of raw vegetables purchased from street vendors and the consumption of meals outside home were also associated with H.pylori infection.
Conclusions:
Foods may represent an important route in the transmission of H. pylori among humans.
... which has been demonstrated under various experiment (Wen et al., 2003;Puupponen-Pimia et al., 2005;Rodríguez-Vaquero et al., 2007a, b;Monica et al., 2009;Boban et al., 2010;Isohanni et al., 2010). Murray et al. (2002) showed that the consumption of wine reduces health risk by 6% demonstrating that wines have potent antimicrobial activity against foodborne pathogens. In this study, we found that white and red wine with 11.5% alcohol had high antimicrobial activity against C. jejuni with the minimum microbicidal concentrations of 10% dilution for white and 25% for two red wines while Monica et al. (2009) reported higher antimicrobial activity of red wine (10%) than white wine (25%) by giving credit to the high level of phenolic compound that red wine contain. ...
Forty-three (43) Campylobacter jejuni isolated from sheep feces and carcass swab samples by conventional culture method were 100% confirmed by polymerase chain reaction (PCR) test. The nucleotide sequences of 362 bp showed 100% homology to the completed genome of C. jejuni subsp. M1 and 81116. Antimicrobial property of different types of wine against C. jejuni was investigated. White wine and two red wines with 11.5% ethanol significantly reduced the viability of C. jejuni. The minimum bactericidal concentration of white wine and for both red wines was 10 and 25%, respectively. C. jejuni lost their viability when frozen or refrigerated at-20 and 4°C. The reduction rates of C. jejuni were 0.54-1.02 logCFU/ml during storage at 4°C, whereas it exhibited 0.72-1.52 logCFU/ml during storage at-20°C.
... [6] For example, moderate consumption of wine and beer (approximately 7 units/ wk) appears to protect against H. pylori infection, presumably by facilitating eradication of the organism. [8] The consumption of alcohol, particularly of wine, may reduce the risk of developing an active H. pylori infection. [9] Furthermore, heavy alcohol intake may be associated with reductions in the prevalence and severity of H. pylori infection. ...
This study aimed to explore the effects of active and latent Helicobacter pylori infection coupled with alcohol consumption on cytokine profiles and markers of oxidative balance in men seropositive for H. pylori CagA Ab.
The 100 male subjects were divided into groups with active H. pylori infection and H. pylori CagA Ab coupled with chronic alcohol ingestion (group A, n = 38), latent H. pylori infection with H. pylori CagA Ab coupled with chronic alcohol ingestion (group B, n = 30), and latent H. pylori infection with H. pylori CagA Ab without chronic alcohol ingestion (group C, n = 32).
No differences in serum levels of CRP, IL-10, ADP, E-selectin, MDA, or SOD were detected between the 3 groups or between any 2 groups (all P > .05). The serum IL-6 and TNF-α concentrations in groups A and B were significantly lower than those in group C (P = .004, P = .005, P = .009, and P = .023). However, there were no differences in serum IL-6 and TNF-α between group A and group B (all P > .05).
In conclusion, active or latent H. pylori infection coupled with chronic alcohol ingestion may decrease certain cytokines, that is, IL-6 and TNF-α, in men with H. pylori CagA Ab seropositivity. However, there was no difference in the detected cytokine profile between active and latent H. pylori infection coupled with chronic alcohol ingestion, and no changes were detected in markers of oxidative balance in men with H. pylori CagA Ab.
... Of note, one study showed that alcoholic beverages have some bactericidal activity. For this reason, regular wine (1 glass/day) or beer (0.5 pint/day) consumption was found to prevent H. pylori infection [34]. In addition, some studies have indi- cated that alcohol consumption contributes to the effi- cacy of H. pylori eradication [35,36]. ...
Background/aims:
The eradication rate of the first-line triple therapy (a proton pump inhibitor, clarithromycin, and amoxicillin) for Helicobacter pylori infection has gradually decreased in Korea. We evaluated whether clinical parameters, clarithromycin resistance, and CYP2C19 genotype can affect the eradication failure.
Methods:
A total of 203 patients with H. pylori-positive chronic gastritis were consecutively enrolled. They received clarithromycin-based triple therapy for 7 days. A clarithromycin resistance test was performed by detection of A2142G and A2143G point mutations in H. pylori 23S rRNA. The CYP2C19 genotype was examined for polymorphism G681A of exon 5 and G636A of exon 4 by polymerase chain reaction with restriction fragment length polymorphism. Eradication was assessed by a 13C-urea breath test 4 weeks after treatment.
Results:
Of 203 patients, 190 completed the study. The eradication rate was 64.0% according to intention-to-treat analysis and 68.4% by per-protocol analysis. CY-P2C19 genotypes were identified as follows: 75 poor metabolizers, 75 intermediate metabolizers, and 40 rapid metabolizers. Nonetheless, this polymorphism was not significantly associated with eradication failure (p = 0.682). Clarithromycin resistance was detected in 33/190 patients (17.4%), and their eradication rate was zero. Clarithromycin resistance (odds ratio [OR], 19.13; 95% confidence interval [CI], 9.35 to 35.09) and female gender (OR, 1.73; 95% CI, 1.15 to 4.25) were significantly associated with eradication failure. The other clinical parameters such as age, cigarette smoking, alcohol intake, the body mass index, hypertension, and diabetes were not significantly associated with eradication.
Conclusions:
Clarithromycin resistance and female gender are factors affecting H. pylori eradication failure in patients with chronic gastritis.
... A cross-sectional population study was conducted on 10,537 subjects as part of a randomized controlled trial of H. pylori infection eradication in southwest England. After adjustment for different parameters, it was found that subjects drinking 3 to 6 units of wine or beer/week had lower risk of H. pylori infection compared with those who took no wine, presumably by facilitating eradication of the organism [99]. In a previous study, same association was observed but was slightly more pronounced for alcohol from wine than alcohol from beer [100]. ...
Helicobacter pylori are a widespread chronic infection that accompanied man from long ago. The infection is responsible for the majority of peptic ulcer, stomach cancer and dyspeptic symptoms. Large-scale eradication therapy regimens are linked with a rapid increase in antibiotic resistance. Moreover, different regimens used for therapy require multiple-day complex drug administration and are associated with side effects which can lead to treatment discontinuation. Our diet contains many substances with proven bacteriostatic or bactericidal properties against H. pylori. Although these food products are not proven to allow permanent H. pylori eradication, they can reduce bacterial colonization, the degree of stomach inflammation, thus potentially lowering the risk of gastric adenocarcinoma development.
... The patients with smoking habit had more positivity rate to H. pylori infection (90.5 %) as compared to those without previous history of smoking (68.3% ), this difference was statistically significant (p< 0.05) as shown in Table (3.8). The relationship between H. pylori infection and smoking was suggested in some studies (Woodward et al., 2000;Murray et al., 2002 andSantos et al., 2005). While other studies showed no association of smoking with H. pylori infection (Everhart et al., 2000 andAkin et al., 2004). ...
The present study was carried out to investigate the frequency of
H. pylori infection and its association with ABO, Lewis blood groups and
secretor status among patients with various gastroduodenal symptoms.DNA fingerprinting has also
been assessed for H. pylori to determine whether there was any genetic
heterogeneity among H. pylori isolates recovered from the patients according
to their ABO blood groups. Also the applicability of the 229 bp domain of
16SrRNA for the detecting of H. pylori was evaluated.
... In this study, alcohol consumption was the significant clinical factor influencing H. pylori eradication rate, particularly in patients with CLD (p Z 0.022). Alcohol consumption was reported to be associated with a small, but not statistically significant, decrease in the odds of H. pylori infection and it appeared to have an additive effect in the triple eradication therapy [32]. However, there were other studies showing that alcohol consumption was not relevant to the success of H. pylori eradication [33,34]. ...
Helicobacter pylori eradication in patients with chronic liver diseases (CLDs) and liver cirrhosis is seldom reported. This study aimed to assess the efficacy of 7-day standard triple therapy in patients with CLD including cirrhosis and to investigate the clinical factors influencing the success of eradication. A total of 592 H. pylori-infected patients, who received 7-day standard first-line triple therapy between January 1, 2014, and December 31, 2014, were recruited. Patients were divided into two groups: CLD group (N=136) and non-CLD group (N=456). The eradication rates attained by the CLD and non-CLD groups were 86.0% and 84.2%, respectively, in the per-protocol analysis (p=0.606). The eradication rates of liver cirrhosis and noncirrhosis CLD were 88.5% and 84.3%, respectively (p=0.783). The adverse events were similar between the two groups (8.8% vs. 9.2%, p=0.891). Compliance between the two groups was good (99.3% vs. 99.6%, p=0.670). The univariate analysis showed male sex to be the significant clinical factor in the non-CLD group (p=0.001) and alcohol consumption to be the significant clinical factor influencing H. pylori eradication rate in patients with CLD (p=0.022). Alcohol consumption was the only significant factor influencing H. pylori eradication in multivariate analysis (odds ratio=3.786, p=0.031). The results of this study suggest that H. pylori eradication rates in patients with CLD may be comparable with non-CLD patients. Alcohol consumption was the significant factor influencing H. pylori eradication in patients with CLD.
... In this study, although the most prevalent blood group was blood type O (43%), subjects with blood group O didn't show an increased susceptibility to H. pylori infection than those with other blood groups (p>0.05) [12,16,[30][31][32][33][34]. ...
... Intake of alcohol during or after consumption of contaminated food may protect against Salmonella spp. ( Bellido-Blasco et al ., 2002 ), and consumption of beverages with Ͼ 10% alcohol provided a protective effect against Hepatitis A from oysters ( Desenclos et al ., 1992 ). Furthermore, moderate alcohol consumption suppresses Helicobacter pylori infection ( Brenner et al ., 1997 ;Brenner et al ., 2001 ;Murray et al ., 2002 ). ...
Pathogenic (disease-causing) microorganisms cannot survive in beer due to the presence of various inhibitory factors/hurdles. The major intrinsic hurdles that a pathogen must overcome to survive in a beer are the presence of ethanol produced by yeasts during fermentation (up to 10% (v/v), typically 3.5-5.0% (v/v)), hop ( Humulus lupulus ) bittering compounds (approx. 17-55 parts per million iso -α-acids), low pH (approx. 3.9-4.4), carbon dioxide (approx. 0.5% (w/w)), low oxygen (<0.1 ppm), and the lack of nutritive substances. Ethanol and hops interfere with essential cell membrane functions, the low pH hinders enzyme activity, the lack of nutrients and oxygen starves many potential pathogens, whilst elevated dissolved carbon dioxide lowers the pH, inhibits enzymes, affects cell membranes, and creates an anaerobic environment. In addition to these intrinsic factors, many stages of the brewing process reduce the potential for contamination, such as mashing, wort boiling, pasteurization, filtration, aseptic packaging and cold storage. Various studies have shown that the survivability of pathogens such as Escherichia coli , Salmonella Typhimurium, and Vibrio cholerae in most beers is very poor. However, beers without, or with, reduced levels of one or more of these antimicrobial " hurdles " are more prone to the survival and/or growth of pathogenic organisms. Examples are low-alcohol and unpasteurized beer, for which special attention must be paid to ensure their safety.
... On the other hand, it seems that there is an inverse correlation between alcohol consumption and the prevalence of H. pylori infection [33][34][35] . ...
Alcohol has a direct impact on the digestive system due to its contact with mucosal lining and interference with digestive functions. Various diseases of the gastrointestinal tract, including tumors, may be related to an excess of alcohol intake and the relationship between alcohol abuse and hepatic and pancreatic damage is well established. According to WHO, alcohol and alcohol-related diseases represent a major health problem and will probably continue to do so in the foreseeable future. In this review, we summarize the present knowledge on clinically relevant alcohol-related problems in order to provide practicing physicians with evidence-based general suggestions which might help in the management of alcohol-related gastrointestinal disorders. A thorough clinical history together with a number of questionnaires are essential for detecting alcohol dependence or abuse. Biochemical tests (nonspecific and specific) have been considered to be less sensitive than questionnaires in screening for alcohol abuse, but they may be useful in identifying relapses. Protracted behavior modification, cognitive behavioral therapy, psychological counseling, and mutual support groups have been considered the most effective long-term treatments. Several drugs have been developed that are able to interfere with the neurotransmitters involved in craving mechanisms, and we summarize the evidence of their efficacy to increase abstinence and to prevent relapse.
... A history of alcohol intake was also significantly linked to a less likely detection of H. pylori. In a crosssectional study conducted by Murray et al [37] the OR for H. pylori infection among consumers of 7-13 units of alcohol/week was 0.83 (95%CI: 0.70-0.98). The role of exercise has not been seen to significantly affect the detection of H. pylori (OR = 0.721, 95%CI: 0.393-1.321). ...
To investigate the influence of proton pump inhibitors (PPIs) exposure on the diagnosis of Helicobacter pylori (H. pylori) gastritis and intestinal metaplasia.
Chronic PPI use is associated with masking of H. pylori infection. Patients with H. pylori infection are predisposed to gastric and duodenal ulcers, and long-term infection with this organism has been associated with gastric mucosal atrophy and serious long-term complications, such as gastric lymphoma and adenocarcinoma. Three hundred patients diagnosed with gastritis between January 2008 and April 2010 were included in our study. The computerized medical database of these patients was reviewed retrospectively in order to assess whether the type of gastritis diagnosed (H. pylori vs non-H. pylori gastritis) is influenced by PPI exposure. H. pylori density was graded as low, if corresponding to mild density following the Updated Sydney System, or high, if corresponding to moderate or severe densities in the Updated Sydney System.
Patients were equally distributed between males and females with a median age at the time of diagnosis of 50 years old (range: 20-87). The histological types of gastritis were classified as H. pylori gastritis (n = 156, 52%) and non-H. pylori gastritis (n = 144, 48%). All patients with non-H. pylori gastritis had inactive chronic gastritis. Patients with no previous PPI exposure were more likely to be diagnosed with H. pylori gastritis than those with previous PPI exposure (71% vs 34.2%, P < 0.001). Intestinal metaplasia was more likely to be detected in the latter patients (1.4% vs 6.5%, P = 0.023). Multivariate analysis has also demonstrated that in the presence of previous PPI exposure (OR = 0.217, 95%CI: 0.123-0.385), GERD (OR = 0.317, 95%CI: 0.132-0.763, P = 0.01), alcohol intake (OR = 0.396, 95%CI: 0.195-0.804, P = 0.01), the detection of H. pylori was less likely. Chronic use of PPIs may mask H. pylori infections promoting the diagnosis of non-H. pylori gastritis and leads to a significant drop in H. pylori densities and to an increased risk of intestinal metaplasia.
The use of PPIs masks H. pylori infection, promotes the diagnosis of non-H. pylori inactive chronic gastritis diagnosis, and increases the incidence of intestinal metaplasia.
... (16), and consumption of beverages with >10% alcohol was reported to provide a protective effect against Hepatitis A from oysters (17). Furthermore, moderate alcohol consumption suppresses Helicobacter pylori infection (18)(19)(20). ...
Beer is a beverage that is produced in a multistage process, where some stages of that process are intentionally influenced by microorganisms, while at other stages of the production process microorganisms are actively discouraged. Most of the intentional microbial activity is facilitated by yeast; however bacteria also play an influential role in beer production. This paper will describe the beneficial role of bacteria in the beer production process (the Good), but will also pay due attention to the negative influences bacteria might have on the quality of beer as a commodity (the Bad), and the properties of beer that have given it the status of an inherently safe food for human consumption with regards to disease-causing bacteria (the Ugly). Copyright © 2013 The Institute of Brewing & Distilling
Aim.
In vitro antimicrobial activities of seven wines (5 reds and 2 whites) from the Douro region (Iberian Peninsule) against eleven clinical strains of Helicobacter pylori were evaluated.
Methods.
The disk diffusion method, using Columbia Agar supplemented with horse blood (CAB), were used to determine the antimicrobial properties of some wine components against H. pylori strains. Potential interactions of antioxidants contained in the wines and two antimicrobials (amoxicillin and metronidazole) were studied by the disk diffusion method.
Results.
All the tested strains showed growth in CAB supplemented with 9% of the tested wines but none of them grew in media supplemented with 45% and 67.5% of wine. Similarly, all the tested strains grew in media with the concentration of proanthocyanidins present in the different types of the studied wines. The Minimal Inhibitory Concentration (MIC) values of the wine antioxidant components tested (benzoic acid, catechin, quercetin, and resveratrol) indicate that resveratrol was the most powerful inhibitory substance against H. pylori. An effect of potentiation between amoxicillin and metronidazole and the antioxidants tested was also established. The interaction of amoxicillin and resveratrol or metronidazole and catechin increased the antimicrobial activity against H. pylori.
Conclusions.
The results obtained suggested a potential role of resveratrol as a chemopreventive agent for H. pylori infection.
Background:
The association between drinking and Helicobacter pylori infection was not clear in the literature. Owing to mixed and inconclusive results, a meta-analysis was conducted to summarize and clarify this association systematically.
Methods:
Based on a comprehensive search of PubMed, Embase, and Web of Science databases, studies investigating the association between drinking and H. pylori infection were retrieved. We evaluated the strength of this relationship using odds ratios (ORs) with 95% confidence intervals. Sensitivity analysis was also conducted.
Results:
A total of 24 individual studies were included in this meta-analysis. The risk of H. pylori infection was significantly lower in alcohol drinkers than nondrinkers (OR=0.83). People who drink wine (OR=0.90) or mixed types of alcoholic beverages (OR=0.78) had a lower risk of infection compared with those who drink beer. Among people aged 40 years or older, alcohol drinkers had a lower risk of H. pylori infection than nondrinkers (OR=0.68). Among people less than 40 years of age, alcohol drinking was not associated with H. pylori infection risk. Data showed that women were at a lower risk of H. pylori infection than men (OR=0.86).
Conclusions:
This meta-analysis suggests that the risk of H. pylori infection among alcohol drinkers is lower than that of nondrinkers. Drinking wine and mixed types of alcohol are better at reducing H. pylori infection than drinking beer. Nonetheless, we discourage reducing H. pylori infection through drinking, which increases the risk of other diseases.
As Helicobacter pylori infection is highly prevalent estimated to be affecting more than 50% of the world’s populations and implicated in the pathogenesis of several gastric diseases including gastric cancer, early detection of infection even before symptoms appears to be one of the most important strategies in management. This study was aimed to detect infection by ¹⁴C Urea Breath Test and to describe the risk factors in asymptomatic adults at Kanbauk village-tract, located in Southern Myanmar. It was a community-based, cross-sectional prevalence study conducted between 4th to 9th October 2019. After thorough history taking, physical examination, obtaining informed consent, and fasting for 5 hours, H. pylori infection was detected by ¹⁴C urea breath testing. Among 149 volunteers, infection was detected in 68.46% of the study population. The prevalence of H. pylori infection in male patients was 66.7% and in female patients was 75%. There was no statistically significant association between H. pylori infection and gender (p=0.36). The mean age of H. pylori infected patients was 37.4 years (SD ± 9.14) and it did not differ significantly (p=0.421). Subjects who never attended government school were found out to have a significant association with H. pylori infection (p=0.006). Other factors such as family income, household numbers, smoking, betel chewing habit, alcohol consumption, BMI and blood groups were found to be no significant risk factors for H. pylori infection. The prevalence of H. pylori in Kanbauk village tract was comparable to two different community studies conducted in Myanmar.
Acute and chronic gastrointestinal problems are common in the setting of excessive alcohol use and excessive alcohol use is associated with injury to all parts of the gastrointestinal tract. There is mounting evidence of gastrointestinal injury and increased cancer risk even from moderate alcohol consumption. The major causes of alcohol‐related morbidity and mortality within the gastrointestinal system are liver disease, pancreatitis and gastrointestinal cancer. Other alcohol related intestinal dysfunction is common but not life‐threatening leading to diarrhea, malabsorption and nutritional deficiencies. This review describes non‐neoplastic and neoplastic alcohol related disorders of the gastrointestinal tract omitting the liver which has been reviewed elsewhere.
Beer is one of the oldest alcoholic beverages consumed by humanity, having been discovered about 7.000 years ago. When consumed in moderate quantities, beer can bring similar health benefits to wine. Despite the great economic, cultural and scientific importance of beer, there are few reports in Portuguese literature focused on the topic. In this sense, the main objective of this paper is to gather information in the scientific literature about the chemical aspects involved in brewing, as well as the analytical techniques used in their characterization, authentication and control of the productive processes, and the biological activities that compounds of beer ownes. Beer is produced basically by four essential ingredients: water, malt, hops and yeast. These ingredients are handled in seven steps: milling, mashing, boiling, fermenting, conditioning, filtering, and packaging. At the final stage of production, manufactures can evaluate physicochemical properties of the beer, of which it is highlighted alcohol content, bitterness, color, and pH. In the identification of beer compounds, as well as in the authentication and control of production processes, can be used analytical techniques such as infrared (IR) spectroscopy, hydrogen nuclear magnetic resonance (¹H NMR), mass spectrometry (MS) and gas Chromatography coupled to mass spectrometry (GC-MS). In addition, studies on the biological activities of compounds present in the beer reveal an antioxidant, anti-inflammatory, antimicrobial, antitumor potential, among others, noting that moderate consumption of the beverage can bring benefits to the health of consumers.
Helicobacter pylori (Hp) infection is closely related to chronic active gastritis, peptic ulcer, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer, and is also associated with some parenteral diseases. Eradication of Hp can significantly improve gastric mucosal inflammatory response, prevent or delay gastric mucosal atrophy, intestinal metaplasia and its development, partially reverse atrophy, and reduce the risk of gastric cancer in varying degrees. In recent years, the eradication failure rate has increased. There are many reasons for the failure of Hp eradication. Previous studies have suggested that Hp resistance to antibiotics is the main cause of eradication failure, but recent studies have found that poor compliance is the main reason.
Background: Gastric ulcers are one of the most prevalent gastro intestinal diseases. Perforation of gastric ulcer is most common and dreaded complication of a gastric ulcer. Causes of gastric ulcer include Helicobacter Pylori, the NSAID, smoking and alcohol. Helicobacter Pylori infection is a curable cause of gastric ulcer. As prevalence of H. pylori differ in populations, prevalence of H. pylori in our population need to be assessed for determining treatment strategy for gastric ulcer.Methods: Cross sectional study conducted in patients operated for perforation peritonitis and diagnosed to have gastric ulcer perforation in a tertiary care centre. Full thickness biopsy was taken from gastric ulcer perforation edge during the surgery for perforation peritonitis. The biopsy was stained with Giemsa stain and looked for the presence of H. pylori.Results: Helicobacter pylori prevalence was 48.8% in our study. 8 females (out of 16) and 51 males (out of 105) had H. pylori positivity. 43 had history of smoking. Among them 20 were diagnosed to be having H. pylori positive. 26 persons had history of pan chewing. Among pan chewers 17 were H. pylori positive. Among 50 patients with history of alcoholism, 24 got H. pylori positivity. Among 40 patients with history of NSAIDs, 14 were positive for H. pylori.Conclusions: Prevalence of Helicobacter pylori in gastric ulcer perforation in present study is 48.8%. Helicobacter Pylori eradication should be added in treatment protocols for perforated gastric ulcers.
The gastrointestinal microbiome is a complex echosystem that establishes a symbiotic, mutually beneficial relation with the host, being rather stable in health, but affected by age, drugs, diet, alcohol, and smoking. Alcohol and smoking contribute to changes in the stomach and affect H pylori-related disorders including the risk of gastric cancer. In the small intestine and in the colon alcohol causes depletion of bacteria with anti-inflammatory activity, eventually resulting in intestinal damage with "leaky gut". These changes contribute to hepatic damage in both alcoholic and non-alcoholic liver disease and have been associated with other disorders. Lactobacillus GG and A. muciniphila exert a protective effect in this setting. Smoking leads to modifications of the gut microbiome linked with a protective effect toward ulcerative colitis and deleterious for Crohn's disease. The exact cause-effect relation between alcohol and smoking and changes of the gastrointestinal microbiome needs further exploration with high throughput methodologies, and controlled studies are necessary to define the role of microbiome modulation on the immune response and systemic activation of pro-inflammatory pathways.
Diet may provide noxious agents which increase the pathogenicity of H. pylori, or protective agents that hamper their activity. The scope of this chapter is to elaborate on how dietary modulations and lifestyle habits can affect the course of H. pylori infection. We depict the role of several dietary components that may protect against the pathological consequences of H. pylori infection, and thus improve patient’s eradication therapy. Considering H. pylori as a strong and established risk factor of peptic ulcer, we also provide evidence between dietary exposure and the probability of tumor formation and/or prevention.
The relative risks of coronary heart disease (CHD) and overall mortality are reduced by moderate consumption of alcoholic beverages, particularly wine, which has major implications for public health. It appears likely that this beneficial effect of alcohol will soon be extended to some mental disorders. Although data on psychosis and mood and anxiety disorders are currently lacking, it appears that the relative risks of developing ischaemic stroke and Alzheimer's or vascular dementia are also lowered by moderate alcohol consumption. Such findings are still tentative because of the inherent methodological problems involved in Population-based epidemiological studies, and it is unclear whether the benefit can be ascribed to alcohol itself or to other constituents specific to wine such as polyphenols. Plausible biological mechanisms have been advanced for the protective effect of alcohol and wine against CHD, many of which will also play roles in their protective actions against cerebrovascular disease and dementia. The specific antioxidant properties of wine polyphenols may be particularly important in preventing Alzheimer's disease. Because of the substantially unpredictable risk of progression to problem drinking and alcohol abuse, the most sensible advice to the general public is that heavy drinkers should drink less or not at all, that abstainers should not be indiscriminately encouraged to begin drinking for health reasons, and that light to moderate drinkers need not change their drinking habits for health reasons, except in exceptional circumstances.
The effects of chronic abuse of alcohol and/or other substances of abuse vary considerably, depending, for example, on the concentration and dose. Furthermore, other factors also may play a role, such as nutritional status, gender, and ethnicity. This chapter analyzes the main medical consequences related to substance abuse, namely alcohol, nicotine, opioids, cocaine, amphetamine, and benzodiazepines. The effects of these substances on the liver, gut, pancreas, nervous system, cardiovascular system, and endocrine system are analyzed and discussed. The link between substance abuse disorders and tumors is also reported, as well as the relationship between substances of abuse and nutrition and body composition.
This chapter contains section titled:
Background:
Alcohol intake has been suggested to have an impact on the development of many chronic diseases. How alcohol intake may modulate risk of Helicobacter pylori (H. pylori) infection, however, remains a subject open for investigation. A dose-response meta-analysis was performed of epidemiological studies to better quantify this relationship.
Materials and methods:
Twelve observational articles were identified. The summary odds ratio (OR) and confidence intervals (CI) were calculated for alcohol drinkers vs non-drinkers. The summary OR estimates were obtained using the random-effects model and dose-response meta-analysis. Sub-group and sensitivity analysis were also conducted.
Results:
The summary OR was 0.78 (95% CI = 0.69-0.89). The dose-response analysis demonstrated that for drinkers of 10, 15, 30, 60 and 96 g/day alcohol intake, the estimated ORs were 0.80 (95% CI = 0.76-0.85), 0.79 (95% CI = 0.75-0.84), 0.83 (95% CI = 0.78-0.87), 0.85 (95% CI = 0.78-0.93) and 0.87 (95% CI = 0.70-1.06), respectively, compared to non-drinkers. The inverse relationship between alcohol intake and H. pylori infection was consistent, regardless of sex, age, geographic areas, detection methods or beverage types.
Conclusion:
Evidence from these observational studies suggests that moderate alcohol intake is associated with a reduction in H. pylori infection of ∼ 22% and may facilitate elimination of H. pylori.
Distributions, trends and risk factors for Helicobacter pylori infection, peptic ulcer and gastric adenocarcinoma are reviewed. Persistent H. pylori infection, affecting approximately half of the world's population, may lead to peptic ulcer, gastric adenocarcinoma, or MALT lymphoma. H. pylori prevalence in each birth cohort (generation) reflects the risk of acquisition that prevailed during the cohort members’ childhood. Peptic ulcer may affect, at some point in life, 4–12% of the adult population, and the population-attributable risk for H. pylori is 48%. Due to its poor prognosis, gastric adenocarcinoma ranks number two among all causes of cancer death (more than 10% of all cancer deaths), with two-thirds of the cases occurring in developing countries. There has been a steep downward trend in the incidence of distal stomach cancer – but not for cardia cancer – among white men and women.
A common belief prevails in society that alcohol stimulates the appetite and "improves digestion". In this article the author carries out a systematic review of the negative effects of alcohol consumption upon different organs of the digestive system. Moreover, new research results are presented, which support an unconventional idea of a positive impact of consumption of moderate amounts of alcoholic beverages, especially red wine, on the digestive system. This comprises, among others, antibacterial activity against Helicobacter pylori, a protective effect against the ulcerogenic effect of ethanol on gastric mucosa, and even antitumor activity. Responsible for these beneficial actions are flavonoids occurring in alcoholic beverages, such as wogonin, and polyphenols, among which the leading role is played by resveratrol present in red wine, and ellagic acid contained in whisky, brandy and cognac.
The gastric barrier contains several lines of defense which protect the epithelium from harmful microbes and toxins. Pre-mucosal defense mechanisms include secreted acid (HCl 0.1mmol/L) and pepsin, which are capable of denaturing tissue. A tightly adherent mucous layer provides the next line of defense, and physically separates any potentially hazardous substance in the lumen from the mucosal surface. Apical secretion of HCO3- maintains a non-acidic microenvironment at the mucosal surface. Membrane-bound phospholipids repel soluble toxins, and sulphydryls scavenge reactive oxygen species. However, when noxious agents overwhelm these mechanisms, the epithelium is damaged. Herein, we discuss the pathological and physiological basis for several disease states which are associated with a breakdown in one or more components of the gastric barrier, including: Helicobacter pylori-associated gastritis, atrophic gastritis, stress-related mucosal disease, age-related gastropathy and portal hypertensive gastropathy. The effect of non-steroidal anti-inflammatory drugs and proton pump inhibitors on the gastric mucosa, is explored. Finally, we outline the alterations in mucosal defense caused by alcohol, caffeine, minerals and vitamins.
Objective:
The aim of this study is to investigate the relationship between oral problems and Helicobacter pylori (Hp) infection, and to reveal which oral problems are significantly related with Hp infection.
Methods:
Participants undergoing healthy medical examination were examined for 12 kinds of oral problems: dental calculus, oral mucosal disease, periodontal disease, decayed tooth, tooth defect, disuse tooth, residual crown and root, devital tooth, loose tooth, fistula, ill-fitting fixed denture and ectopic tooth. Hp infection was confirmed by (13)C-urea breath test. Participant information including age, educational level, smoking habits, drinking habits, height, weight and body mass index (BMI) were collected using a standard questionnaire.
Results:
Hp infection was 46.97% of the 54,036 cases. Age (P<0.01), gender (P<0.001) and BMI (P<0.01) were significantly associated with Hp infection. Smoking (P<0.001) and regular drinking (P<0.001) were showed to be associated with Hp infection. After adjustments for other associated factors, in all of the 12 oral problems, only dental calculus [n=35,559, OR (95% CI)=1.05 (1.01-1.09), P=0.012] and loose tooth [n=2411, OR (95% CI)=1.22 (1.03-1.22), P=0.007] were related with Hp infection.
Conclusion:
In a cross-sectional analysis, the prevalence of Hp infection was strongly related with several social problems, including age, gender, BMI, smoking and regular drinking. In addition, oral problems, particularly dental calculus and loose tooth, were found to be associated with Hp infection, possibly due to the dental plaque. The study suggested that to prevent or eradicate Hp infection, we need to focus on oral hygiene and prevention of oral problems, especially dental calculus and loose tooth.
Red and white wines without added sulfite were tested for antibacterial activity against stationary-phase grown cells of Escherichia coli O157:H7, Listeria monocytogenes, Salmonella Typhimurium, and Staphylococcus aureus. The wines had bactericidal activity against all strains, with the red wine being most potent. S. Typhimurium was most sensitive, with 6 log reduction after 10 min exposure to wine, whereas S. aureus appeared least sensitive to the wines. Mutants having the gene encoding the alternative sigma factor disrupted were generally more sensitive to wine than their wild-type counterparts. When different combinations of ethanol, organic acids, and acidity were tested against the pathogens, it was found that a composition of 0.15% malic acid, 0.6% tartaric acid, 15% ethanol, and pH 3.0 had a strong bactericidal effect. The compounds in the mixture seemed to act synergistically against the pathogens. The pathogens grew in 25% to 40% white wine diluted in brain hearth infusion broth, with S. aureus being able to grow at the highest concentration of wine. Preincubation of the bacteria in sublethal concentrations of wine and ethanol and pH 4.5 did not increase their tolerance against wine or against the mixture of organic acids and ethanol. In conclusion, wine had an antibacterial effect against the pathogens tested. The synergistic effect of organic acids, ethanol, and low pH seems to be responsible for a major part of the antibacterial effect of wine. The alternative sigma factors seemed to be involved in protection of the bacteria against wine.
Resistance is also an increasing problem for antibiotic based therapy of Helicobacter Pylori infection. A para-digm shift in the treatment of infectious disease may be useful to prevent the further emergence of antibiotic resistance. Some daily-consumed food and beverages, including tea, lactobacillus, alcohol and garlic, have anti-helicobacter activities in-vitro. In epidemiological studies consumption of tea was associated with decreased risk of Helicobacter Pylori infec-tion. Supplementation of Lactobacillus improved the tolerance of antibiotic based Helicobacter eradication therapy. How-ever, few controlled clinical trials have been published and most are methodologically weak. Controlled trial had shown that lactobacillus alone was not effective in eradicating Helicobacter Pylori infection. Otherwise, controlled trial of plant extracts or non-antibiotic based therapy for Helicobacter Pylori infection has not been available yet. Overall, currently available evidences concerning these alternative strategies are still scanty, but promising. Further investigations, espe-cially randomised controlled trials, are needed to investigate the role of these alternative strategies in preventing Helico-bacter Pylori infection, and find out how these food or beverages should be used to augment the efficacy of antibiotic based therapies.
The main dietary sources of polyphenols are reviewed, and the daily intake is calculated for a given diet containing some common fruits, vegetables and beverages. Phenolic acids account for about one third of the total intake and flavonoids account for the remaining two thirds. The most abundant flavonoids in the diet are flavanols (catechins plus proanthocyanidins), anthocyanins and their oxidation products. The main polyphenol dietary sources are fruit and beverages (fruit juice, wine, tea, coffee, chocolate and beer) and, to a lesser extent vegetables, dry legumes and cereals. The total intake is ∼1 g/d. Large uncertainties remain due to the lack of comprehensive data on the content of some of the main polyphenol classes in food. Bioavailability studies in humans are discussed. The maximum concentration in plasma rarely exceeds 1 μM after the consumption of 10–100 mg of a single phenolic compound. However, the total plasma phenol concentration is probably higher due to the presence of metabolites formed in the body's tissues or by the colonic microflora. These metabolites are still largely unknown and not accounted for. Both chemical and biochemical factors that affect the absorption and metabolism of polyphenols are reviewed, with particular emphasis on flavonoid glycosides. A better understanding of these factors is essential to explain the large variations in bioavailability observed among polyphenols and among individuals.
The cross sectional study describes the prevalence of infection with Helicobacter pylori as determined by a serodiagnostic assay in over 3000 asymptomatic subjects, in two age groups 25-34 years and 55-64 years, from 17 geographically defined populations in Europe, North Africa, North America, and Japan, using a common protocol for blood collection and serological testing. In all populations combined, the prevalence of infection was higher in the older age group (62·4%) than in the younger age group (34·9%). There was no difference in prevalence of infection between men and women. Subjects with higher education had considerably lower levels of infection (34·1%) compared with subjects with education up to secondary level (46·9%) or those with primary education only (61·6%). This trend was confined to the older of the two age groups. In contrast a trend of increasing prevalence of infection with increasing body mass index was confined to the younger of the two age groups. There was no effect of smoking or alcohol consumption on the prevalence of infection after adjusting for the other risk factors. There was considerable variation in the prevalence of infection between the 17 populations but, within populations, low education standard was consistently and positively associated with the prevalence of infection.
The seroprevalence of IgG antibodies to Helicobacter pylori was determined using a standard enzyme linked immunosorbent assay in a population of 749 randomly selected men, aged 30-75 years, from Caerphilly, South Wales. The overall prevalence of H pylori was 56.9%, increasing sharply in middle age from 29.8% in those aged 30-34 to over 59% in those aged 45 or older (p less than 0.0001). Age standardised seroprevalence rates were lowest in combined social class categories I and II (49.2%), intermediate in categories IIIN and M (57.5%), and highest in categories IV and V (62.2%) (p = 0.01). In those aged 30-34 years, the prevalence rate for those in combined social class categories IV and V was 57.9% - double the rate for social class categories IIIM and N (28.3%) and five times the prevalence rate in those in social class categories I and II (11.1%). These differences in the infection patterns of H pylori by social class are consistent with patterns of peptic ulcer disease and gastric cancer.
To relate the prevalence of infection with Helicobacter pylori in adults to their living conditions in childhood to identify risk factors for infection.
Prevalence study of IgG antibodies to H pylori (> 10 micrograms IgG/ml, determined by enzyme linked immunosorbent assay (ELISA)) and reported living conditions and other socioeconomic factors in childhood.
Three factories in Stoke on Trent.
471 male volunteers aged 18 to 65 years.
Seroprevalence and variables in childhood.
Seroprevalence of H pylori increased with age (22/74 (29.7%) at < 30 years v 29/46 (63%) at 55-65 years; P < 0.001 for trend) and was related to manual occupation (14/65 (21.5%) for non-manual v 162/406 (39.9%) for manual; P = 0.003). After data were adjusted for age and occupation subjects from large families, whose childhood homes were crowded or who regularly shared a bed in childhood, were significantly more likely to be seropositive (adjusted odds ratio (95% confidence interval) 2.15 (1.41 to 3.30) for crowding and 2.13 (1.38 to 3.30) for sharing a bed), but there was no relation with possession of a bathroom, inside toilet, refrigerator, or household pets in childhood.
Close person to person contact in childhood is an important determinant of seroprevalence of H pylori in adulthood, suggesting that the infection is transmitted directly from one person to another and may be commonly acquired in early life.
To test whether red and white wines are as potent as bismuth salicylate against the bacteria responsible for traveller's diarrhoea to try to explain wine's legendary reputation as a digestive aid.
Red and white wine, bismuth salicylate, two solutions containing ethanol (diluted absolute ethanol and tequila), and sterilised water were tested against suspensions of salmonella, shigella, and Escherichia coli to determine relative antibacterial activity. Suspensions of 10(7) colony forming units of shigella, salmonella, and E coli were added to the test solutions and plated on standard nutrient agar at 0, 10, 20, 30, 60, and 120 minutes and 24 hours. Dilutions of wine and bismuth salicylate were then tested with E coli as the test bacterium, and the experiment repeated.
Exposure times necessary for eradication of organisms for the different solutions; decreases in colony counts at the different exposure times for dilutions of wine and bismuth salicylates.
Undiluted wine and bismuth salicylate were both effective in reducing the number of viable organisms (by 10(5)-10(6) colony forming units) after 20-30 minutes. Dilutions of wine were much more effective in decreasing colony counts than were similar dilutions of bismuth salicylate.
The antibacterial property of wine is largely responsible for wine's reputation as a digestive aid.
A cohort of Swedish children was monitored from 6 months to 11 years of age. Immunoglobulin G (IgG) and IgA antibodies to Helicobacter pylori were measured in 1,857 serum samples, drawn at the ages of 6, 8, 10, 18 months and 2, 4, and 11 years. Of the 294 children, 40 (13.6%) were found to have been infected at some time. However, at 11 years of age, only 6 of 201 (3%) children were seropositive. The highest seroprevalence of positive results, 10%, was found at 2 years of age, and the highest incidence of 13.3% could be calculated for the period between 18 months and 2 years of age. There were no confirmed additional cases for children between 4 and 11 years of age. Infection with H. pylori thus occurs at an early age in a developed country (as well as in developing countries), and spontaneous clearance seems to be common.
Despite the widespread prevalence and serious clinical sequelae of infection with Helicobacter pylori, there have been few large population-based studies, using randomly selected subjects, examining the epidemiology of this infection.
To examine the distribution and determinants of H. pylori infection in a developed country.
Overall 4742 subjects, aged 12-64, from Northern Ireland were randomly selected.
Helicobacter pylori specific IgG antibodies were measured by enzyme linked immunosorbent assay, using an acid-glycine extract antigen, in stored serum from subjects who had participated in three linked population-based surveys of cardiovascular risk factors performed in 1986 and 1987.
The overall prevalence of H. pylori infection was 50.5%. Prevalence increased with age from 23.4% in 12-14 year olds to 72.7% in 60-64 year olds: chi 2 for trend 518, P < 10(-4). In subjects aged > or = 25, infection was more common in males (60.9%) than females (55.2%): chi 2 = 9.53, P < 0.01. This relation remained significant after adjusting for age, and measures of socioeconomic class: odds ratio (OR) for infection, male versus female was 1.19 (95% confidence interval [CI]: 1.02-1.40). Infection was associated with social class: the adjusted OR of infection in subjects from manual social classes relative to those from non-manual classes was 1.7 (95% CI: 1.47-1.98). Infection was significantly more common in current smokers and ex-smokers than in subjects who had never smoked: adjusted OR for infection, ex-smokers versus never smoked was 1.22 (95% CI: 1.01-1.49); for smokers of > or = 20/day versus never smoked OR = 1.33 (95% CI: 1.05-1.67). Infection was not associated with height in adult males but mean height in infected women was lower than in uninfected women after adjusting for age and socioeconomic status: difference in mean height (SE), -0.85 cm (0.32), P < 0.01. There was no demonstrable relationship between H. pylori infection and current alcohol intake.
This study demonstrated a high prevalence of infection in a population from a developed country. Previously reported associations between H. pylori infection, age, sex, social class, and reduced height in females were confirmed and smoking was identified as a possible risk factor for H. pylori infection.
The natural history of Helicobacter pylori infection in humans is not well established. We aimed to systematically review the literature on the natural acquisition and spontaneous elimination of the infection and its clinical consequences.
A broad-based MEDLINE and Current Contents search was performed to identify all related publications between 1986 and 1996. Abstracts from recent major conferences that provided adequate data were also included.
The prevalence of H. pylori infection increases with age, the rates being significantly lower in developed countries than in developing countries. However, the overall prevalence is decreasing in both developing and developed countries, which probably is responsible for the steep decline of gastric cancer in some industrialized countries. The natural acquisition of H. pylori infection occurs, for the most part, in childhood, and it appears that the incidence is currently slightly higher in developing countries than in industrialized countries. Spontaneous elimination of the infection also occurs, especially in young children and the elderly. The route of transmission continues to be uncertain, with the best evidence favoring both the gastro-oral and fecal-oral routes. Low socioeconomic status is a major risk factor for acquisition of the infection. Genetics probably plays a role in the acquisition or clearance of H. pylori infection in individuals.
Low rates of natural acquisition and elimination of the infection in adults suggest that it is worthwhile to eradicate the organism from adults, but there should be further evaluation of the need for eradication of H. pylori in children.
To assess the relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection.
Cross sectional study of patients attending a general practitioner. Active H pylori infection was measured by the 15C-urea breath test and detailed quantitative information on smoking and on alcohol and coffee consumption was obtained by a standardised self administered questionnaire.
One general practice in Germany.
447 patients aged 15-79 who had not had peptic ulcer disease or treatment for H pylori infection.
Prevalence of H pylori infection according to smoking and alcohol and coffee consumption.
Overall prevalence of infection was 21% (94/447). There was no significant relation between smoking and active H pylori infection. Alcohol consumption showed a negative dose-response relation and coffee consumption a positive dose-response relation with active infection. After adjustment for potential confounders, the odds ratios for patients who drank < or = 75 g and > 75 g of ethanol a week compared with non-drinkers were 0.90 (95% confidence interval 0.55 to 1.59) and 0.33 (0.16 to 0.68), respectively (P value for trend 0.005, assuming that 1 litre of beer and 0.51 of wine contain on average 50 g of ethanol in south Germany). Adjusted odds ratios for patients who drank < 3 cups and > or = 3 cups of coffee per day compared with those who did not drink coffee were 1.49 (0.71 to 3.12) and 2.49 (1.23 to 5.03), respectively (P value for trend 0.007).
These results suggest a protective effect of alcohol consumption against active infection with H pylori and an opposite effect of coffee consumption.
Alcoholic beverages are known to have strong antibacterial activity. It is unclear, however, to what degree their consumption
affects colonization of the human stomach with the bacterium Helicobacter pylori, a risk factor of various chronic diseases. The authors assessed the relation between alcohol consumption and active infection
with H. pylori in a cross-sectional study among employees of a health insurance company and their household members (n=425) in southern Germany. Quantitative information on alcohol consumption by beverage type and other factors that were known
or suspected to be related to infection status was collected by a standardized questionnaire, and active infection was measured
by the 13C-urea breath test. After control for confounding factors, there was a monotonic inverse graded relation between alcohol consumption
and H. pylori infection (P for trend=0.017). The odds ratio of infection among subjects who consumed more than 75 g of alcohol per week compared with
subjects who did not drink alcohol was 0.31 (95 percent confidence interval 0.12–0.81). The inverse relation with H. pylori infection was stronger for alcohol consumed in the form of wine than for alcohol from beer. Notwithstanding its cross-sectional
design, this study seems to support the hypothesis that alcohol consumption, particularly wine consumption, may reduce the
odds of active infection with H. pylori. Am J Epidemiol 1999;149: 571–6.
To assess the patterns of alcohol consumption in France and Northern Ireland.
Four cross-sectional studies.
Sample of 50-59 y old men living in France and Northern Ireland, consuming at least one unit of alcoholic beverage per week.
5363 subjects from France and 1367 from Northern Ireland.
None.
Consumption of wine was higher in France whereas consumption of beer and spirits was higher in Northern Ireland. Alcohol drinking was rather homogeneous throughout the week in France, whereas Fridays and Saturdays accounted for 60% of total alcohol consumption in Northern Ireland. In both countries, current smokers had a higher consumption of all types of alcoholic beverages than non-smokers. Similarly, obese and hypertensive subjects had a higher total alcohol consumption than non-obese or normotensive subjects, but the type of alcoholic beverages differed between countries. In Northern Ireland, subjects which reported some physical activity consumed significantly less alcoholic beverages than sedentary subjects, whereas no differences were found in France. Conversely, subjects with dyslipidemia consumed more alcoholic beverages than normolipidemic subjects in France, whereas no differences were found in Northern Ireland. In France, total alcohol, wine and beer consumption was negatively related to socioeconomic status and educational level. In Northern Ireland, total alcohol, beer and spirits consumption was negatively related whereas wine consumption was positively related to socioeconomic status and educational level.
Alcohol drinking patterns differ between France and Northern Ireland, and also according to cardiovascular risk factors, socioeconomic and educational levels.
Merck, Sharp & Dohme-Chibret (France), the NICHSA and the Department of Health and Social Service (Northern Ireland).
BACKGROUND: On may 1994, a foodborne outbreak took place in Almazora (Castellón, Spain) after a meal with 116 persons. A sanitary study was made to find out the causes and control the outbreak. SUBJECTS AND METHODS: Inspection of the setting and a case-control study were carried out. Several foods and faecal specimens of 23 patients were investigated. We also study the effect of alcohol on the occurrence of the outbreak. RESULTS: A hundred people was interviewed (86%), 58 ill persons. Salmonella enteritidis was isolated from faeces and statisticaly implicated food (odds ratio = 75, IC 95 = 15.6-361), a sandwich with tuna, boiled eggs and vegetables. Among adults, epidemiological analysis showed a protective effect of alcohol, adjusted for age, sex and consumption of the implicated food (p = 0.007). CONCLUSIONS: In the study of foddborne outbreaks by Salmonella enteritidis simultaneous consumption of alcoholic drinks and foods should be taken into account to explain some exposed non-cases.
Infection with Helicobacter pylori is the main cause of peptic-ulcer disease. Treatment of this infection might lower the prevalence of dyspepsia in the community and improve quality of life. We investigated this possibility in a double-blind randomised controlled trial.
Individuals aged 40-49 years were randomly selected from the lists of 36 primary-care centres. A researcher interviewed participants with a validated dyspepsia questionnaire and the psychological general wellbeing index (PGWB). H. pylori status was assessed by the carbon-13-labelled urea breath test. Infected participants were randomly assigned active treatment (omeprazole 20 mg, clarithromycin 250 mg, and tinidazole 500 mg, each twice daily for 7 days) or identical placebo. Participants were followed up at 6 months and 2 years.
Of 32,929 individuals invited, 8455 attended and were eligible; 2324 were positive for H. pylori and were assigned active treatment (1161) or placebo (1163). 1773 (76%) returned at 2 years. Dyspepsia or symptoms of gastro-oesophageal reflux were reported in 247 (28%) of 880 in the treatment group and 291 (33%) of 871 in the placebo group (absolute-risk reduction 5% [95% CI 1-10]). H. pylori treatment had no significant effect on quality of life (mean difference in PGWB score between groups 0.86 [-0.33 to 2.05]).
Community screening and treatment for H. pylori produced only a 5% reduction in dyspepsia. This small benefit had no impact on quality of life.
Acute ingestion of pure ethanol has been reported to delay gastric emptying and to enhance the propulsive movements of the intestine. The aim of the present study was to investigate the comparative effect of beer (7.0% v/v), white wine (7.5% v/v), ethanol (7.5% v/v), and water on the gastric emptying of a liquid test meal and on the gastrocaecal transit time of lactulose added to the test meal. Gastric liquid emptying was assessed by means of a nasogastric intubation technique using polyethylene glycol 4000 as the non-absorbable marker. The gastrocaecal transit time was evaluated by a hydrogen breath test. Beer (P less than 0.001) and white wine (P less than 0.05) significantly accelerated gastric emptying in comparison with ethanol of the same concentration. The gastrocaecal transit time was significantly shorter when the liquid meal was administered with beer compared with ethanol (P less than 0.005) and water (P less than 0.01). The constituents in beer and white wine responsible for our observations remain to be found.
This in vitro study was undertaken to determine the potential for survival of enteric pathogens in common drinking beverages. Three carbonated soft drinks, two alcoholic beverages, skim milk, and water were inoculated with Salmonella, Shigella, and enterotoxigenic Escherichia coli, and quantitative counts were performed over 2 days. Our studies showed poorest survival of all three organisms in wine, and greatest growth in milk and water. Beer and cola allowed survival of small numbers of Salmonella and E. coli at 48 h, whereas sour mix and diet cola were sterile by 48 h. Survival features may correlate with pH of the beverages. These observations may be useful in guiding travellers for appropriate beverage consumption while visiting areas endemic for "traveller's diarrhea."
The action of intragastric ethanol in various concentrations (1.4%-40% vol/vol) and of beer, white wine, cognac, and whisky on gastric acid secretion and release of gastrin was studied in healthy humans. Ethanol concentrations of 1.4% and 4% (vol/vol), but not higher, significantly (p less than 0.05) increased gastric acid secretion to 23% and 22%, respectively, of incremental maximal acid output [i.e., observed response to pentagastrin (6 micrograms/kg s.c.) minus basal acid output]. The 1-h incremental gastric acid responses to beer and wine were 96% and 61%, respectively, of incremental maximal acid output. Neither cognac nor whisky had any stimulatory effect. The 1-h incremental gastric acid response to an 8% peptone meal was 40% of incremental maximal acid output, and to peptone plus white wine 77%. Plasma gastrin levels were not altered by ethanol, cognac, and whisky. The 1-h integrated plasma gastrin responses to beer and white wine were 119% and 77%, respectively, of the response to the peptone meal. We conclude that (a) the action of pure ethanol on gastric acid secretion is related to its concentration: concentrations of 1.4% and 4% are moderate stimulants; concentrations of 5%-40% have no effect, or rather an inhibitory effect; (b) beer and white wine, but not whisky and cognac, are potent stimulants of gastric acid secretion; (c) the stimulatory mechanism of low ethanol concentrations is unknown; and (d) nonalcoholic constituents of beer and wine are most likely responsible for the stimulatory actions of both beverages on gastric acid secretion and release of gastrin.
After almost 40 years of water fluoridation in the United States, its effect in the food chain is now being appreciated. Current surveys indicate significant increases in the F content of infant formulas, toddler cereals, fruit juices, and popular beverages, largely because fluoridated water is used in their processing. According to the best estimates, the daily total F intake of children from foods, beverages including water, and other sources such as unintentional ingestion of dentifrices containing F is on the rise, although it is generally within the currently accepted range for this age group. It is encouraging to note that appropriate steps are now being taken by some manufacturers of infant formulas to monitor F levels and keep them within an acceptable range. Because of the increasing contribution of dietary F to total F intake, dietary F should be included in any estimate of daily total F intake in children before F supplements are prescribed, whether the children live in communities with fluoridated or nonfluoridated water. To achieve this goal, it is essential to develop a generally accepted, sensitive method for the analysis of F in foods and beverages. This should help develop the bioavailability profiles for individual foods and beverages essential for accurate assessment of dietary F intake. Fluoridated salt, used in some European countries, appears to be the only food ingredient currently in use as an alternative to water fluoridation. Attempts to utilize staple foods and beverages as vehicles for systemic F delivery have generally failed because of the decreased bioavailability of F in such products, and because it is difficult to make them available to the general population and especially to the lower socioeconomic segments of the population.
On may 1994, a foodborne outbreak took place in Almazora (Castellón, Spain) after a meal with 116 persons. A sanitary study was made to find out the causes and control the outbreak.
Inspection of the setting and a case-control study were carried out. Several foods and faecal specimens of 23 patients were investigated. We also study the effect of alcohol on the occurrence of the outbreak.
A hundred people was interviewed (86%), 58 ill persons. Salmonella enteritidis was isolated from faeces and statistically implicated food (odds ratio = 75, IC 95 = 15.6-361), a sandwich with tuna, boiled eggs and vegetables. Among adults, epidemiological analysis showed a protective effect of alcohol, adjusted for age, sex and consumption of the implicated food (p = 0.007).
In the study of foddborne outbreaks by Salmonella enteritidis simultaneous consumption of alcoholic drinks and foods should be taken into account to explain some exposed non-cases.
The effect of commonly ingested alcoholic beverages on gastric acid output and release of gastrin in humans is unknown.
In 16 healthy humans the effect of some commonly ingested alcoholic beverages produced by fermentation plus distillation (for example, whisky, cognac, calvados, armagnac, and rum) or by alcoholic fermentation (beer, wine, champagne, martini, and sherry) on gastric acid output and release of gastrin was studied. Gastric acid output was determined by the method of intragastric titration. Plasma gastrin was measured using a specific radioimmunoassay.
None of the alcoholic beverages produced by fermentation plus distillation had any significant effect on gastric acid output and release of gastrin compared with control (isotonic glucose and distilled water). Alcoholic beverages produced only by fermentation significantly (p < 0.05) increased the gastric acid output by 57% to 95% of maximal acid output (MAO) and release of gastrin up to 5.1-fold compared with control. If beer, wine, and sherry were distilled, only their remaining parts increased gastric acid output by 53% to 76% of MAO and increased release of gastrin up to 4.3-fold compared with control.
(1) Alcoholic beverages produced by fermentation but not by distillation are powerful stimulants of gastric acid output and release of gastrin; (2) the alcoholic beverage constituents that stimulate gastric acid output and release of gastrin are most probably produced during the process of fermentation and removed during the following process of distillation.
The 13C-urea breath test (13C-UBT) is the method of choice in evaluating the success of therapy for eradication of Helicobacter pylori infection. For reasons of cost efficiency and practicability, urea dose and measurement duration have been reduced and the DOB (delta over baseline) cutoff level with the highest predictive value determined. Further, the efficacy of the modified 13C-UBT as a semi-quantitative test method was evaluated by comparison with histologically determined bacterial infiltration.
In a prospective study, a modified 13C-UBT with reduced urea dose (75 mg) and shortened measurement duration (30 min) was administered to 145 patients. The DOB cutoff with the highest predictive value was determined using relative operating characteristic analysis. Reference methods included histology, bacterial culture and the rapid urease test. The DOB value was compared with the histologically determined grade of bacterial infiltration and the correlation evaluated using the Spearman ranking method.
Reduction of the DOB cutoff level from 5.0 per thousand to 3.5 per thousand led to significant improvement in sensitivity (78.9% vs. 91.2%) and accuracy (88.6% vs. 90.2%) of the 13C-UBT. Only five of 57 infected patients were incorrectly reported as non-infected after modification of the DOB level. In two of three patients in whom histological findings were negative but the 13C-urease test positive, bacterial growth was observed at culture. The DOB level correlated significantly with histological grade of bacterial infection.
The modified 13C-UBT proved to be a sensitive, practicable and cost-effective method for detecting H. pylori infection and permits a semi-quantitative estimation of bacterial infiltration.
Alcohol has strong antimicrobial activity and stimulates gastric acid secretion. Alcohol consumption may therefore compromise the living conditions of Helicobacter pylori in the stomach. We assessed the relation of alcohol consumption with H. pylori infection among 1,785 participants ages 18-88 in the German National Health and Nutrition Survey. Detailed information on dietary and lifestyle habits was obtained in personal interviews using a standardized food frequency questionnaire. Serum samples were analyzed for H. pylori immunoglobulin G antibodies by enzyme-linked immunosorbent assay. Overall prevalence of H. pylori infection was 39.2%. There was a clear inverse dose-response-relation between reported alcohol consumption and H. pylori infection. The relation persisted after control for potential confounding factors. The adjusted prevalence ratios (95% confidence intervals) for H. pylori infection among persons who consumed up to 10, 10 to 20, and more than 20 gm of alcohol per day compared with non-drinkers were 0.93 (0.77-1.13), 0.82 (0.65-1.04), and 0.71 (0.55-0.92). The inverse relation between alcohol consumption and H. pylori infection was even stronger when individuals with an indication of a recent change of alcohol consumption were excluded from the analysis. These findings support the hypothesis that moderate alcohol consumption may facilitate spontaneous elimination of H. pylori infection among adults.
This study aims to estimate the prevalence of Helicobacter pylori in Glasgow, and to provide a systematic analysis of factors associated with this prevalence. The data used are from a random population sample of 793 men and 838 women aged 25-64 years conducted in 1995. The prevalence is estimated to be 66% (95% confidence interval: 63-68%); a level that is more typical of developing countries. Prevalence increases with age and social deprivation (P<0.0001) and is slightly higher in men than women (P = 0.07). After adjustment for age, social class, and sex group, H. pylori prevalence increases with increased cotinine (tobacco consumption) (P = 0.0005), increased number of siblings (P<0.0001), and decreased height (P = 0.03). Prevalence of coronary heart disease, hypertension, diabetes and intermittent claudication, alcohol consumption, fibrinogen, total serum cholesterol, HDL cholesterol, triglycerides, marital status, systolic and diastolic blood pressure had no independent association. The infection seems to be spread more readily in deprived, relatively crowded living conditions in childhood. The independent relationship with smoking suggests a possible second source of spread of infection in later years. The high degree of social deprivation in Glasgow is suggested as a major explanation of the high H. pylori prevalence found there.
Helicobacter pylori is a major cause of various gastroduodenal diseases. Some risk factors related to H. pylori infection have been reported; however, studies on the relationship between H. pylori infection and smoking or drinking habits have given conflicting results. In the present study, these relationships were investigated by collecting sera and information from 8837 subjects.
Serum H. pylori immunoglobulin G antibody was measured by an enzyme-linked immunoassay. In addition to sex and age, information on smoking and drinking habits was collected by questionnaire. Age- and sex-adjusted odds ratios (95% confidence interval) of smoking and alcohol consumption were calculated for H. pylori seropositivity using logistic regression models.
Current smokers had a 0.82 (0.74-0.91)-fold greater risk of H. pylori seropositivity than those who had never smoked. Current cigarette consumption showed a dose-dependently negative association with H. pylori seropositivity, and the association between smoking and H. pylori infection was strong in younger subjects. Current drinkers had a 0.88 (0.79-0.98)-fold greater risk of H. pylori seropositivity than those who had never drunk alcohol. The volume of alcohol consumed showed a negative association with H. pylori seropositivity.
In the current study, smoking was negatively associated with H. pylori infection. The risk of H. pylori seropositivity decreased linearly with cigarette consumption per day. Increased gastric acidity in the stomach through smoking may be a cause of the dose-dependently negative association between H. pylori and smoking. Drinking was negatively and dose-dependently associated with H. pylori positivity, although the effect of drinking was weaker than that of smoking.
This study examines the association between lifestyle factors, chronic disease, body-indices, and the seroprevalence of Helicobacter pylori infection in Danish adults. The relationship between age at menarche and H. pylori infection is also assessed. A random sample of 3,608 Danish adults completed a questionnaire about lifestyle factors (smoking habits, alcohol consumption, and coffee and tea intake), doctor diagnosed chronic diseases (heart conditions, diabetes, chronic bronchitis, and hypertension), menarche, and socio-demographic factors. A total of 2,913 participants were eligible for the present study. Electrocardiographs were recorded and blood pressure and serum lipid levels (HDL cholesterol, triglyceride, and cholesterol) were measured. Height and weight were determined and body mass index (BMI) calculated. Sera were analysed with an enzyme-linked immunosorbent assay for the presence of H. pylori specific IgG antibodies. The seroprevalence of H. pylori infection was associated with weekly alcohol intake > or = 6 drinks (odds ratio 0.7, 95% confidence interval 0.6-0.9) due to a low rate of H. pylori infection among wine drinkers (odds ratio 0.6, 95% confidence interval 0.5-0.7). No associations were found with smoking habits or serum lipids. People with upper quartile BMI (> or = 26.8 kg/m2) were more likely to be seropositive for antibodies to H. pylori (odds ratio 1.6, 95% confidence interval 1.1-2.4). Chronic bronchitis (odds ratio 1.6, 95% confidence interval 1.1-2.5) and unspecified heart condition (odds ratio 2.0, 95% confidence interval 1.1-3.3) was more often seen in IgG seropositive women than in uninfected women. The likelihood of being seropositive for IgG antibodies to H. pylori increased with age at menarche (odds ratio per year 1.10, 95% confidence interval 1.02-1.19). Previously reported associations with age and socioeconomic status were confirmed. We conclude that wine drinking is associated with lower rates of H. pylori infection in Danish adults. The seroprevalence of H. pylori infection is increased in people with high BMI. H. pylori infection may relate to a history of late menarche and chronic bronchitis in Danish women.
The main dietary sources of polyphenols are reviewed, and the daily intake is calculated for a given diet containing some common fruits, vegetables and beverages. Phenolic acids account for about one third of the total intake and flavonoids account for the remaining two thirds. The most abundant flavonoids in the diet are flavanols (catechins plus proanthocyanidins), anthocyanins and their oxidation products. The main polyphenol dietary sources are fruit and beverages (fruit juice, wine, tea, coffee, chocolate and beer) and, to a lesser extent vegetables, dry legumes and cereals. The total intake is approximately 1 g/d. Large uncertainties remain due to the lack of comprehensive data on the content of some of the main polyphenol classes in food. Bioavailability studies in humans are discussed. The maximum concentration in plasma rarely exceeds 1 microM after the consumption of 10-100 mg of a single phenolic compound. However, the total plasma phenol concentration is probably higher due to the presence of metabolites formed in the body's tissues or by the colonic microflora. These metabolites are still largely unknown and not accounted for. Both chemical and biochemical factors that affect the absorption and metabolism of polyphenols are reviewed, with particular emphasis on flavonoid glycosides. A better understanding of these factors is essential to explain the large variations in bioavailability observed among polyphenols and among individuals.
Regardless of the type and dose of beverage involved, alcohol facilitates the development of gastroesophageal reflux disease by reducing the pressure of the lower esophageal sphincter and esophageal motility. Fermented and nondistilled alcoholic beverages increase gastrin levels and acid secretion. Succinic and maleic acid contained in certain alcoholic drinks also stimulate acid secretion. Low alcohol doses accelerate gastric emptying, whereas high doses delay emptying and slow bowel motility. Alcohol facilitates the development of superficial gastritis and chronic atrophic gastritis--though it has not been shown to cause peptic ulcer. Alcoholic beverages, fundamentally wine, have important bactericidal effects upon Helicobacter pylori and enteropathogenic bacteria. The main alcohol-related intestinal alterations are diarrhea and malabsorption, with recovery after restoring a normal diet. Alcohol facilitates the development of oropharyngeal, esophageal, gastric, and colon cancer. Initial research suggests that wine may be comparatively less carcinogenic.
Alcoholic beverages have antimicrobial effects against Helicobacter pylori in vitro. To elucidate the relation between alcohol consumption and current infection with H. pylori in vivo, we carried out a pooled analysis of three recent studies from Southern Germany, comprising 1410 adults age 15 to 69. Detailed information on consumption of various alcoholic beverages was collected through standardized questionnaires. Helicobacter pylori infection was measured by 15C-urea breath test. Overall, prevalence of current H. pylori infection was lower among subjects who consumed alcohol (34.9%) than among nondrinkers (38.0%). The adjusted odds ratio was 0.79, with a 95% confidence interval of 0.58-1.08. Furthermore, alcohol consumption showed a strong inverse relation to the result of the 13C-urea breath test, a semiquantitative measure of the bacterial load, among infected subjects. The inverse association between alcohol consumption and H. pylori infection was not monotonic, however. Odds of infection were lowest at moderate levels of alcohol consumption and increased at higher levels of alcohol consumption, regardless of the type of alcoholic beverages consumed. These results support the hypothesis that moderate alcohol consumption may favor suppression and eventual elimination of H. pylori infection. At higher levels of alcohol consumption, the antimicrobial effects of alcoholic beverages may be opposed by adverse systemic effects of drinking, such as adverse effects on the immune defense.
The antibacterial activity of sixteen Chilean red wines (Cabernet Sauvignon, Cabernet Merlot, Cabernet Organic and Pinot Noir), and the active extracts of two randomly selected wines were assayed for their antibacterial activity on six strains of Helicobacter pylori isolated from gastric biopsies. The active fraction of the wines was obtained by dichloromethane extraction, and the antibacterial activity of the wines and extracts was evaluated by an agar diffusion method. All the red wines studied showed some antibacterial activity on the six strains of H. pylori, although the strains were heterogeneous in their susceptibility to each particular wine. The active fraction of the two wines selected also showed good activity against the strains tested. The main active compound was identified as resveratrol. The results presented indicate that Chilean red wines have antibacterial activity against H. pylori, which depends mainly on the presence of resveratrol.
As part of a cross-sectional study on cholelithiasis, 1533 out of 1840 residents in Loiano/Monghidoro, a rural area in Northern Italy (792 men, 741 women, age range 28-80 years), agreed to be further evaluated in relation to their Helicobacter pylori status.
Each participant performed a 13C-urea breath test (13C-UBT) and provided information on sociodemographic, lifestyle and clinical characteristics.
The 13C-UBT was positive in 1041 subjects (67.9%; men: 69%; women: 67%) and was positively associated with increasing age (P < 0.001), alcohol consumption (P < 0.01), a higher number of siblings (P < 0.001) and a personal history of peptic ulcer (P < 0.01), but inversely with a nonmanual occupation (P < 0.001). Overall, H. pylori infection was unrelated to smoking, house pets, and a family history of gastroduodenal diseases. The prevalence of H. pylori infection was 72% in subjects reporting one or more dyspeptic symptoms and 65% among asymptomatic participants (P < 0.001); a multivariate analysis showed that only epigastric pain was significantly, although weakly, associated with 13C-UBT positivity.
This large population-based study showed a prevalence of H. pylori infection higher than that reported by serologic surveys in urban areas. Current H. pylori infection was strongly associated with indicators of lower socioeconomic status, alcohol consumption and increasing age. A role of H. pylori infection in determining epigastric pain was suggested.
Drinking: Adults' behaviour and knowledge in 1998
- E Goddard
- T Thomas
Goddard E, Thomas T. Drinking: Adults' behaviour and
knowledge in 1998. Office for National Statistics,1998.
- Ajg November
AJG – November, 2002
Bristol Helicobacter Project
Alcohol consumption and Helicobacter pylori infection; results from the German National Health and Nutrition Survey
- H Brenner
- G Berg
- N Lappus
Brenner H, Berg G, Lappus N, et al. Alcohol consumption and
Helicobacter pylori infection; results from the German National Health and Nutrition Survey. Epidemiology 1999;10:
214 – 8.
- F Daroch
- M Hoeneisen
- Cl Gonzalez
Daroch F, Hoeneisen M, Gonzalez CL, et al. In vitro antibacterial activity of Chilean red wines against Helicobacter pylori. Microbios 2001;104:79 – 85.