Sankeerth Kumar Motupalli
Terry L. Oroszi- Department of Pharmacology & Toxicology, Boonshoft School of Medicine, Wright State University, Fairborn, OH, United States
This systematic review delves into the intricate relationship between Helicobacter pylori (H. pylori) infection and anemia, shedding light on its significance for public health. Helicobacter pylori, a prevalent bacterium associated with gastritis, peptic ulcers, and stomach cancer, is examined alongside anemia, characterized by a deficiency in red blood cells or hemoglobin. Through an exploration of epidemiology, pathophysiological mechanisms, and healthcare implications, this review emphasizes the global distribution and incidence rates of H. pylori infections and anemia. Socioeconomic and environmental factors influencing prevalence are underscored. Diagnostic methodologies and treatment options for both conditions are discussed in detail. Analysis of studies investigating the causal relationship between H. pylori infection and anemia reveals potential mechanisms such as inflammation-induced alterations in iron and vitamin B12 absorption. While evidence suggests a connection between H. pylori infection and anemia, methodological limitations are acknowledged, necessitating further research to establish causality conclusively. The review highlights the importance of healthcare practitioners considering H. pylori screening for patients with unexplained or persistent anemia symptoms, as effective treatment of H. pylori infection may lead to improved anemia outcomes. Challenges such as antibiotic resistance and patient adherence to treatment regimens are identified. In conclusion, ongoing research into the link between H. pylori infection and anemia offers promising insights, albeit with persisting gaps in understanding. Collaborative efforts are required to address methodological challenges and develop tailored prevention and treatment strategies, accounting for variations in prevalence across populations and regions.
Introduction
Background of Helicobacter pylori infection
Helicobacter pylori (H. pylori) is a common bacterium that causes stomach ulcers. Both infected people and tainted food and drink are vectors for the disease’s transmission (1). Gastritis and peptic ulcers are inflammations of the stomach lining that can be brought on by bacterial infections (2).
Infections caused by H. pylori raise the likelihood of developing stomach cancer (3, 4). Helicobacter pylori may infect half of the global population, albeit not all infected people may experience symptoms or consequences. Overcrowding and poorer socioeconomic position contribute to the higher prevalence of the illness in impoverished nations (4). Nausea, gas, fullness, and stomach discomfort are among the many symptoms that can develop as a result of an infection with H. pylori (5, 6). As an opposing viewpoint, some sick individuals may exhibit no symptoms whatsoever. Blood, breath, feces, endoscopy, and biopsy are the gold standards for diagnosing H. pylori infections (7, 8). Medications that reduce stomach acid and antibiotics are common components of treatment plans for esophageal or gastric cancer. To confirm or rule out an H. pylori infection, a visit to the doctor is necessary (8, 9). Your doctor will determine the best course of therapy for you after reviewing the results. A well-treated H. pylori infection can lead to better gut health and less chance of issues (10).
Introduction to anemia
Problems with the protein hemoglobin, which is responsible for transporting oxygen throughout the body, are one medical issue that can cause anemia. Symptoms may manifest as a pale complexion, weakness, difficulty breathing, and severe fatigue. Some possible causes of anemia include anemia itself, a chronic illness, or a hereditary tendency. Based on the root reason, the treatment plan could involve medication, dietary modifications, or nutritional supplements. In order to treat anemia properly, it is necessary to see a doctor (11).
Rationale for the review
Anemia is a condition in which the body’s oxygen-carrying red blood cells are dangerously low in number. Our current knowledge is incomplete; thus, this extensive study aims to address that gap by investigating the link between H. pylori infection and anemia (12). To further understand the connection between these two states, researchers may want to look for trends and patterns in data from several studies. This thorough investigation has the potential to shed light on how H. pylori infection causes anemia (13). Healthcare practitioners must possess a comprehensive grasp of the correlation between anemia and H. pylori infection to effectively treat individuals with both disorders. This information can also be used to guide prevention and treatment strategies (14). A thorough knowledge of this relationship based on evidence is what a systematic review aims to give, and it also lays the groundwork for future research on the issue (14, 15).
Objectives of the review
The purpose of this exhaustive review is to fill in any gaps in our understanding of hemolytic uremic syndrome (H. pylori infection) by reviewing the available information. Researchers can assess the strength of the association between H. pylori infection and anemia by examining the procedures and outcomes of pertinent research. Both present treatment practices and future studies may benefit from the suggestions made in this evaluation. Our ultimate goal is to improve patient care by increasing our knowledge of this link.
Overview of the structure of the review
This review approaches the topic of anemia as it relates to H. pylori infection in a methodical way. A research report consists of the following sections: introduction, methodology, results, discussion, and conclusion.
To emphasize the importance of understanding the context of the relationship between H. pylori infection and anemia, the review starts with a brief summary of the two disorders. The methodologies section lays out the steps for developing a search strategy, finding appropriate articles using established criteria, and gathering and evaluating data. The results section includes not just the study’s outcomes but also a synopsis of the methodology and key findings. In the review’s discussion section, the authors analyze and interpret the data, highlighting any recurring themes or patterns. Also included are suggestions for future research as well as an examination of the research’s limitations. We summarize the main aspects and assess the credibility of the relationship between H. pylori infection and anemia in the last section of the review.
Helicobacter pylori infection
Overview of Helicobacter pylori bacteria
An infection with H. pylori can produce symptoms in the upper small intestine and stomach. The acidic environment of the stomach kills out circular bacteria. Helicobacter pylori infects 50% of the global population (16). There are two possible pathways for pathogen transmission: the fecal–oral and the oral–oral. These pathways can only be activated by direct contact with an infected individual or by ingesting contaminated food or drink (1). In certain cases, symptoms of an H. pylori infection may not be immediately apparent. Very rarely, this can lead to gastritis, stomach cancer, or peptic ulcers, which are open sores in the small intestine or stomach (1, 17).
Blood, feces, or breath tests are the gold standards for diagnosing H. pylori infection (7). Antibiotics and acid-suppressing medications are common components of therapy plans for associated conditions because they eliminate germs and hasten the healing process (18). Crucially, a complete recovery from an H. pylori infection is possible with prompt diagnosis and treatment. In cases of extreme fear or feeling endangered, seeing a doctor should be your top priority (19).
Helicobacter pylori infection rates and frequencies in connection to the fecal–oral and oral–oral disease pathways are high. Consumption of contaminated food or drink, close contact with an infected person, or inadequate handwashing are the three main ways to catch the disease. Regular handwashing and other forms of excellent hygiene greatly reduce the likelihood of transmission (20).
Infections caused by H. pylori are prevalent globally. Half of the world’s population may be infected with these bacteria. The frequency may be affected by a lot of factors, such as your living situation, income, and general happiness (13).
Problems and red flags in the healthcare system
Infection with H. pylori can manifest in a variety of ways, each unique to the individual. While some people could have gastrointestinal side effects such as gas, bloating, nausea, or vomiting, others might not have these symptoms. Intestinal inflammation, or gastritis, is a common cause of indigestion, appetite loss, and discomfort (21). Helicobacter pylori infections can cause all of these major issues. Peptic ulcers, which manifest as obvious lesions in the stomach or the upper part of the small intestine, are a common consequence (22). Symptoms of peptic ulcers include bleeding, GERD, and flatulence. In exceedingly rare instances, H. pylori infection has been associated with an elevated risk of stomach cancer (23). You may rest easy knowing that most people who carry H. pylori will not get stomach cancer. For an accurate diagnosis and treatment plan, seek medical assistance if you suspect you may be infected with H. pylori. If they think you should have gotten the therapy you need, they will suggest testing (24).
Methods for identifying Helicobacter pylori
There are a number of ways to find out if someone has H. pylori. Some approaches that meet this criterion are as follows: Ingesting a solution containing a certain carbon atom allows one to gauge the tidiness of their breath. Helicobacter pylori is responsible for fermentation in the stomach, which results in the inhalation of carbon dioxide gas. Getting a blood test that looks for antibodies that attack H. pylori is one possibility. It should be noted that this test is designed to detect infections that have previously occurred; it is not capable of detecting infections that are currently active (25).
Stool samples can be tested for a variety of things, including genetic material and H. pylori antigens. An endoscope allows a surgeon to examine the stomach by inserting a thin, flexible tube that has a camera into the digestive tract. During the endoscopy, a biopsy may be collected to test for H. pylori (26).
Several factors, including the provider’s preference and the available resources, could influence the diagnostic technique used. Consulting a medical professional is the gold standard for detecting and treating H. pylori infections (27).
Various treatment options
A combination of antibiotics and drugs that reduce stomach acid is used to treat H. pylori infections. This concoction can reduce inflammation, heal ulcers, and fight against microbes. Antimicrobial properties are also retained (19).
Several factors, such as the patient’s history, present antibiotic resistance patterns, and recommendations from local doctors, could impact the final treatment plan. To decrease the production of stomach acid, it is usual to mix many antibiotics with a proton pump inhibitor (PPI) or histamine-2 receptor antagonist (H2RA), such as metronidazole, clarithromycin, or amoxicillin. It does not matter if your symptoms get better before the antibiotic course ends; what matters is that you follow the treatment plan exactly and finish the prescriptions (28). This might lessen the likelihood of a recurrence while also guaranteeing that all germs have been eradicated. It is recommended to consult a medical expert for an accurate diagnosis and treatment plan for an H. pylori infection. The best course of treatment will be decided after carefully reviewing your unique symptoms (10).
Anemia
Definition and classification of anemia
Extremely low hemoglobin levels or a total absence of red blood cells might indicate anemia. Hemoglobin, a protein found in red blood cells, is responsible for transporting oxygen across the body (28). There are a variety of anemias that can arise for various causes. The following are several common forms of anemia:
● Inadequate hemoglobin production can lead to iron deficiency anemia, one of the most common types of anemia (29).
● Anemia caused by a lack of particular vitamins, including folate or vitamin B12, which the body needs to make red blood cells, is known as vitamin deficiency anemia (30).
● Hemolytic anemia is a condition where the rate of red blood cell breakdown is higher than the rate of red blood cell synthesis (30).
● Aplastic anemia is an uncommon disorder that occurs when the bone marrow cannot create enough hemoglobin, white blood cells, and platelets.
● Defective red blood cells, a hallmark of the hereditary disease sickle cell anemia, can block blood arteries and harm organs (31).
There are many other types of anemia, but this one has its specific symptoms and causes. The only way to get a correct diagnosis and treatment plan for anemia is to see a doctor (25).
Identifying potential danger sources
There is a wide variety of causes and consequences of anemia. The following are some of the most popular justifications:
● Low iron levels in the diet lead to anemia. Deficiencies in iron absorption from dietary sources or in the amount of iron consumed can lead to anemia. This could happen if your body has issues absorbing iron from food, if your iron needs are very high for example, during pregnancy, or if you eat a diet low in foods that are rich in iron.
● A lack of certain vitamins, such as folic acid or vitamin B12, can cause anemia. Without these vitamins, the body is unable to produce red blood cells.
● Many chronic diseases manifest as anemia. Deficiency in red blood cell production or cell death causes this condition. Some examples of such illnesses are cancer, autoimmune disorders, and renal disease (32).
● The quantity of red blood cells or iron storage might be diminished due to excessive bleeding, which can occur for several causes such as heavy menstruation, gastrointestinal bleeding, and trauma, possibly resulting in pale skin (32).
● The inability of the body to produce enough red blood cells, as is the case with hereditary disorders such as sickle cell anemia and thalassemia, can cause persistent low red blood cell counts (32).
There are several potential reasons for anemia, including the following:
● Deficiencies in minerals and vitamins, particularly vitamin D and iron, are commonly observed.
● Limitations in either lifetime or red blood cell production indicate the presence of a chronic illness in a patient.
● The body’s iron needs are greatest during periods of heavy or protracted menstruation, pregnancy, and aging (due to reduced absorption in the elderly and other chronic illnesses which can cause anemia).
● Anyone concerned about their health or who has suspicions of anemia should seek the advice of a doctor or nurse. Making a diagnosis and administering therapy are within their area of expertise (32).
Symptoms and clinical signs
Anemia can manifest in a wide variety of ways for a patient. These parameters are determined by the severity and cause of anemia. The major symptoms are as follows:
Weakness and listlessness are symptoms of anemia. When red blood cells are insufficient, oxygen cannot reach the body’s tissue.
Having trouble breathing, particularly during strenuous physical activity, is a symptom of anemia, which is characterized by a decrease in the body’s oxygen supply. Low red blood cell counts might also produce other symptoms, such as pale nails and skin. Your heart is trying to adjust for its decreased oxygen supply when it suddenly rises or reduces its rate (33).
When the brain does not get enough blood, a condition known as anemia develops, causing symptoms including lightheadedness and dizziness.
Reduced blood flow to the extremities might create a chilliness, or a feeling of coldness when touched. This is especially true when it comes to the lower limbs (34).
One sign of anemia is headaches
Although there are other potential causes, anemia is usually the reason behind these symptoms. If you are experiencing any of these symptoms, it is recommended that you consult a medical professional for an accurate diagnosis and to find out about your treatment options (12).
Strategies for acknowledging
Medical professionals frequently conduct a battery of tests to eliminate the possibility of anemia. A few examples are as follows:
● Inquiring about current symptoms, past illnesses, and anything else that can heighten your risk of anemia is part of a comprehensive physical examination and medical history assessment. To get a feel for how you are doing physically, they will perform a physical examination (35).
● Blood tests are necessary for the diagnosis of anemia. Common blood tests include complete blood counts (CBCs), which measure things like red blood cell count, hemoglobin level, and hematocrit. Additional testing may be necessary to identify the kind and underlying cause of anemia (36).
● The storage and transport of iron by the body is the focus of iron research. A frequent form of anemia, iron deficiency anemia, can be better diagnosed using this.
● A bone marrow test is one way to find out if someone has anemia. It is necessary to examine bone marrow samples, which are typically obtained from the hipbone but may also be drawn from other bones (36).
● Identifying the root cause of anemia could need more tests. Vitamin shortages, genetic anomalies, or diseases might be revealed by any of these tests.
Your treatment choices and the specific kind of anemia you have can be discussed with a doctor. You may rely on their extensive expertise to help you through the diagnostic process and obtain the care you need.
Anemia treatment
How anemia is managed and treated depends on the underlying cause and severity of the disorder. Some broad approaches to treatment and administration are as follows:
If iron deficiency is the root cause of anemia, then increasing iron intake through diet may alleviate symptoms. Iron supplements may also be suggested. You may get these vitamins in a liquid form that you can drink orally (37).
Meal modification is necessary. To boost your daily iron intake, eat more beans, veggies, lean meats, and iron-fortified cereals. Consuming extra vitamin C-rich meals is another way to enhance iron absorption (38).
Rapid administration of blood transfusions has the potential to enhance red blood cell count and oxygen-carrying capacity in patients with severe anemia (39).
• Methods for addressing fundamental issues.
● Anemia symptoms may improve if the underlying causes are addressed such as renal illness or some malignancies. Medication and chemotherapy are therapies that may be necessary (40).
● Anemia can be better managed by making certain changes to one’s way of life, such as managing stress, getting adequate sleep, and exercising frequently (40).
● When trying to figure out how to treat anemia, it is crucial to work with a healthcare provider. In certain cases, they may even track your progress and offer you tailored recommendations (40).
Bear in mind that this is only a broad strategy and that every patient’s therapy will be unique. The ideal person to talk to if you are worried or have questions is a nurse or doctor.
Epidemiology of Helicobacter pylori infection and anemia
Geographic distribution and incidence of Helicobacter pylori infections
The frequency of H. pylori infections may vary greatly among individuals and regions. In regions with limited access to sanitation and healthcare, the prevalence of H. pylori infections tends to be higher (41, 42).
According to the World Health Organization, at least half of humanity is infected with H. pylori. In some developing countries, that figure can be as high as 90%, while in others, it might be as low as 20%. Helicobacter pylori infection rates differ between East Asia, South America, and Africa (43, 44). The incidence of sickness in these locations can be attributed to a combination of factors, including overpopulation, inadequate sanitation, and water pollution. Despite how widespread H. pylori is, not everyone infected will have symptoms. To some, the symptoms may not even be noticeable. It is crucial to accurately diagnose and treat those exhibiting symptoms or problems to control the infection and any associated diseases (45).
Worldwide epidemic of anemia
Anemia is a major problem in public health across the world. Anemia is more common in countries with low or medium income, even though it affects more than 25% of the world’s population. This is in line with what the World Health Organization has said. Anemia affects as many as 40%–50% of female children in some parts of sub-Saharan Africa and South Asia (46). An unhealthy lifestyle, a lack of healthcare resources, and a worldwide epidemic of infectious illnesses are all potential reasons. Anemia, though, is not just a problem in underdeveloped nations. Even in nations with a high standard of living, this is a problem; the elderly, pregnant women, and those with preexisting conditions are especially vulnerable (47).
Many individuals are looking for answers because anemia is a prevalent health problem. These therapies aim to tackle the root cause of the illness by addressing it nutritionally and encouraging the increasing usage of iron supplements. Anemia may strike anybody at any moment; therefore, everyone must be aware of the symptoms and how to treat it (15).
A causal relationship study between Helicobacter pylori and hemolytic uremic syndrome
When H. pylori causes inflammation, it might hinder iron absorption from food. Because iron shortage is a symptom of H. pylori infection, it is feasible for the illness to indirectly aggravate anemia. Several researchers have looked at the link between H. pylori infection and anemia.
● Dr. Annibale and colleagues found that individuals with silent gastritis who had iron-deficient anemia had improved health after H. pylori had been treated (48).
● Dr. Qu and colleagues conducted a meta-analysis to analyze the effects of H. pylori infection on iron-deficient anemia.
Their research adds to the growing body of data connecting H. pylori infection with anemia. Their study lays the framework for the discussion. Preliminary data suggest that H. pylori infection might cause anemia; however, this research has not yet confirmed this. The degree to which the two are interdependent may depend on several things, such as the individual’s present nutritional status and health problems (32, 49).
Infection rates caused by H. pylori differ substantially among geographical areas and demographic groups. When we talk about how different countries and individuals are, we usually bring out the most obvious distinctions. Considerations include one’s way of life, cultural standards, level of personal cleanliness, and accessibility to medical treatment. The prevalence of H. pylori infections is higher in areas where access to clean water and sanitation is limited. On the flip side, it is reasonable to expect a lower frequency in areas where medical treatment is more easily accessible and where individuals are more careful about maintaining personal cleanliness. If they wish to understand how the effects may vary in various groups, researchers investigating the effects of H. pylori infection on anemia must consider these alterations (13).
Pathophysiological mechanisms
A possible link between Helicobacter pylori infection and hemolytic uremic syndrome
Helicobacter pylori causes persistent inflammation when it affects the lining of the stomach. Nutrient absorption may be impacted by inflammation’s effects on the stomach mucosa. These alterations may inhibit the production and release of vital molecules (29).
When H. pylori infections occur, it can lead to iron deficiency anemia. The duodenum is the initial section of the small intestine that starts the absorption of iron. On the other hand, persistent inflammation caused by H. pylori might impede this method. Inflammation in the stomach inhibits acid production and binds to proteins that are essential for iron absorption. Iron deficiency anemia can thus develop if the body experiences problems absorbing an adequate amount of iron through food (29).
Similar to how an infection with H. pylori lowers iron absorption, it can also lower vitamin B12 absorption. Gut lining atrophy is a symptom of bacterial atrophic gastritis. The synthesis of intrinsic factor, a protein necessary for the absorption of vitamin B12 in the small intestine, can be reduced by thicker intestinal mucosa. Deficiency in the absorption of intrinsic factor, often known as vitamin B12, results in megaloblastic anemia (50).
Iron deficiency anemia and megaloblastic anemia are two types of hemolytic anemia that can occur when H. pylori produces alterations and persistent inflammation in the stomach mucosa, which in turn inhibits minerals from being absorbed (51, 52).
Helicobacter pylori infection and its effects on iron uptake and utilization
Iron absorption and metabolism are impeded by the persistent inflammation caused by H. pylori infections. Damage to the stomach lining from the inflammation can interfere with the formation of gastric acid and the activity of proteins needed for iron absorption. The duodenum is the initial section of the small intestine that starts the absorption of iron. Worse yet, inflammation caused by an H. pylori infection may obstruct the process, resulting in deficiencies in iron absorption from food. Additional factors to consider include proteins that aid in the absorption of iron and problems with the generation of stomach acid (50).
Another complication of an H. pylori infection is atrophic gastritis, which is characterized by a thickening of the stomach lining. This disease can exacerbate iron metabolism impairments. An indirect influence on iron metabolism is the decreased generation of intrinsic factors caused by a thinner stomach lining. Without protein intrinsic factors, vitamin B12 absorption is not possible. Helicobacter pylori infections, which alter the stomach lining and induce chronic inflammation, are the most common causes of iron deficiency anemia (53). A therapy for inflammation caused by H. pylori is vital for maintaining optimal iron levels and optimal health (25).
The relationship between Helicobacter pylori and gastric reflux, inflammation, and mucosal integrity
Infection with H. pylori can significantly impact stomach mucosa’s inflammation and integrity. Chronic inflammation of the stomach lining can lead to bacterial gastric mucosal alterations. When the immune system responds to H. pylori by releasing inflammatory mediators, inflammation levels rise. Prolonged inflammation of the gastric mucosa has the potential to cause injury. When mucosal integrity is compromised, several things can happen. The production and secretion of gastric acid and intrinsic factor, two crucial stomach components, can be prevented (54). Intrinsic factor is necessary for vitamin B12 absorption, and stomach acid aids in digestion and nutritional absorption. Another possible complication is atrophic gastritis, which causes loss of mucosal integrity and the stomach lining to become thinner. Nutrient absorption and digestion are already compromised due to this condition’s reduction in stomach acid and intrinsic factor production (32).
Several issues with digestion and absorption can arise from an H. pylori infection, which causes inflammation of the stomach and loss of mucosal integrity. Managing the illness is essential for maintaining a healthy stomach and overall well-being (55).
A probable causal relationship between Helicobacter pylori-induced chronic gastritis and pernicious anemia
Chronic gastritis caused by H. pylori is not directly caused by pernicious anemia. The intrinsic factor-producing parietal cells in the stomach are destroyed by an autoimmune disease, which is the underlying cause of pernicious anemia. To absorb vitamin B12, an intrinsic factor is required. However, an H. pylori infection can indirectly induce pernicious anemia (56–58). The stomach lining may thin down, a condition called atrophic gastritis, due to persistent inflammation caused by H. pylori (57, 59). A decrease in intrinsic factor production may be possible as a result of the disorder’s ability to alter the parietal cells responsible for its creation. Intrinsic factor absorption issues can lead to pernicious anemia and vitamin B12 deficiency. Helicobacter pylori-induced chronic gastritis patients may get pernicious anemia due to low intrinsic factor levels (51, 56).
Implications for healthcare quality
Planning the diagnosis and treatment of H. pylori-induced anemia includes a complete evaluation of the possible impacts on healthcare systems.
Healthcare practitioners should consider screening for H. pylori infection if patients develop unexplained or persistent symptoms after ruling out other probable causes of anemia. If patients with anemia are proven to have an H. pylori infection, it is also possible to utilize effective care measures. For example, taking medications for H. pylori infections can cure anemia and improve iron levels. On the other hand, contacting a doctor is crucial if you are feeling under the weather or have been alerted to have anemia. They can discover what is causing the anemia by researching each patient’s particular condition before reaching a final conclusion.
Limitations and challenges
There are several gaps in our current knowledge of the mechanisms by which H. pylori infection leads to anemia. There may be methodological issues with studies that attempt to prove that H. pylori infection causes anemia. One should think about how long it will take to finish the study, how many people will be questioned, and whether or not there are any confounding variables. Because people and locations are unique, it is difficult to draw broad conclusions from studies. Several factors, such as variations in genetics, environmental influences, and dietary choices, can cause research results to differ. It may be challenging to demonstrate a causal relationship between anemia and H. pylori infection. There is evidence to imply a connection, but to show a causal association, more comprehensive research methodologies are required to consider other potential variables (60).
Anemic patients may be more challenging to evaluate for H. pylori eradication therapy effectiveness. Variables including antibiotic resistance, reinfection rates, and patient adherence to medication regimens might affect treatment outcomes. Constant vigilance and conformity to ethical norms are necessary in research with human subjects. Any research that claims to be ethical must ensure the safety, confidentiality, and informed consent of the study participants (10).
Conclusion
In conclusion, while there are limitations and challenges in our understanding of the relationship between H. pylori infection and anemia, ongoing research is expanding our knowledge in this area. Collaborative efforts among researchers are essential to overcome these challenges and find innovative solutions. Studies such as those conducted by Drs. Annibale and Qu and colleagues have shed light on the role of H. pylori infection in conditions like inflammatory bowel syndrome (IBS) and the potential reversal of IBS following H. pylori eradication in individuals with silent gastritis. These studies provide valuable insights into the complex interactions between H. pylori infection and anemia. Evidence suggests that H. pylori infection may lead to anemia through mechanisms such as impaired iron absorption and utilization. However, the reversibility of anemia upon H. pylori eradication underscores the importance of timely diagnosis and treatment of the infection, particularly in cases of iron deficiency anemia. Moreover, the variation in the prevalence of H. pylori infection between different demographics and geographic areas emphasizes the need for tailored prevention and treatment strategies. Socioeconomic factors, personal hygiene practices, and dietary habits play significant roles in determining infection rates, highlighting the importance of considering these factors in research and healthcare planning.
While there is some evidence suggesting a causal relationship between H. pylori infection and anemia, further research is warranted to elucidate the intricacies of this relationship. Understanding these nuances will not only enhance our understanding of the pathophysiology of anemia but will inform the development of more effective prevention and treatment interventions. Finally, despite the challenges and limitations, ongoing research holds promise for advancing our understanding of the nexus between H. pylori infection and anemia, ultimately leading to improved patient care and outcomes.
Author contributions
SM: Writing – original draft, Writing – review & editing. TO: Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s note
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Keywords: Helicobacter pylori (H. pylori) infection, anemia, gastritis, peptic ulcers, stomach cancer, iron deficiency, vitamin B12 deficiency, global distribution
Citation: Motupalli SK and Oroszi TL (2024) The nexus between Helicobacter pylori infection and anemia—a systematic review. Front. Hematol. 3:1423494. doi: 10.3389/frhem.2024.1423494
Received: 25 April 2024; Accepted: 11 July 2024;
Published: 09 August 2024.
Edited by:
John Strouboulis, King’s College London, United KingdomReviewed by:
Ramesh C. Nayak, University of Cincinnati, United StatesMargherita Di Mauro, Bambino Gesù Children’s Hospital (IRCCS), Italy
Copyright © 2024 Motupalli and Oroszi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sankeerth Kumar Motupalli, sankeerthkumarmotupalli1998@outlook.com; Terry L. Oroszi, terry.oroszi@wright.edu