Influence of infection on the prevalence and patterns of upper gastrointestinal symptoms in Nigerians with diabetes mellitus.

Background: Infection with Helicobacter pylori infection is widespread in our environment. However, whether this fact has any bearing on the prevalence and pattern of symptoms referable to the upper gastrointestinal (GI) system in our population of diabetes mellitus (DM) patients has not been much studied.

Aim: We embarked on this study to evaluate if H. pylori infection played any significant role in the prevalence and patterns of upper GI symptoms in type 2 DM patients in Lagos, Nigeria.

Materials And Methods: A case-control design was employed. One hundred consecutive, consenting, and ambulant type 2 DM patients were recruited from the Lagos University Teaching Hospital and 100 age- and sex-matched nondiabetic controls were drawn from medical outpatient clinics of the same hospital. All subjects were investigated for a marker of active infection with H. pylori via stool antigen testing, had anthropometric measurements taken, and completed a structured questionnaire administered to elicit for the presence of various upper GI symptoms over the preceding 3 months prior to the time of the study. The controls were further tested for DM. For analysis, the symptoms were divided into dyspepsia, gastroesophageal reflux (GER), and others.

Results: H. pylori infection status was neither significantly associated with dyspepsia in either cases or controls (χ2 [1] = 2.198, P = 0.138) nor significantly associated with the symptomatic suggestion of GER in either cases or controls (χ2 [1] = 3.742, P = 0.053). Moreover, the same held for the other upper GI symptoms in cases or controls (χ2 [1] = 0.157, P = 0.203). H. pylori infection was detected in 18% of DM patients and 13% of controls, but there was no statistical significance in this difference (χ2 [1] = 0.954, P = 0.329).

Conclusion: Infection with H. pylori does not appear, from the results of this study, to influence the prevalence and patterns of upper GI symptoms in patients with DM in Nigeria.