Helicobacter pylori infection associated with an increased incidence of cholelithiasis: A retrospective real‐world cohort study of 50 832 patients

Abstract

AbstractBackground and AimHelicobacter pylori (H. pylori) infection is a bacterial disease of the stomach that has been associated with an increased incidence of cholelithiasis. While the updated German guideline emphasizes the relevance of H. pylori as a pathogen and recommends eradication therapy, systematic data on the association between H. pylori infection, its eradication, and the subsequent diagnosis of cholelithiasis in Germany are missing.MethodsA total of 25 416 patients with and 25 416 propensity score‐matched individuals without H. pylori infection were identified from the Disease Analyzer database (IQVIA) between 2005 and 2021. A subsequent diagnosis of cholelithiasis was analyzed as a function of H. pylori infection as well as its eradication using Cox regression models.ResultsAfter 10 years of follow‐up, 8.0% versus 5.8% of patients with and without H. pylori infection were diagnosed with cholelithiasis (P < 0.001). Regression analysis revealed a significant association between H. pylori infection and cholelithiasis (hazard ratio [HR]: 1.45; 95% confidence interval [CI]: 1.33–1.58), which was stronger in men (HR: 1.63; 95% CI: 1.41–1.90) than in women (HR: 1.36; 95% CI: 1.22–1.52). In terms of eradication therapy, both an eradicated H. pylori infection (HR: 1.48; 95% CI: 1.31–1.67) and a non‐eradicated H. pylori infection (HR: 1.41; 95% CI: 1.25–1.60) were associated with a subsequent diagnosis of cholelithiasis.ConclusionThe present study reveals a strong association between H. pylori infection and a subsequent diagnosis of cholelithiasis in a large real‐world cohort from Germany. Eradication therapy was not associated with a reduced incidence of cholelithiasis in our cohort.