Evaluation of the frequency of Helicobacter pylori infection and atrophic gastritis in patients diagnosed with celiac disease

Aim: Celiac disease (CD) is a chronic inflammatory enteropathy triggered by an autoimmune response to gluten. This study aimed to determine gastric pathologies accompanying CD, with a focus on the frequency of Helicobacter pylori (H. pylori) infection and atrophic gastritis. Material and Methods: Between January 2010 and March 2018, 47 patients diagnosed with CD at the Gastroenterology Clinic of Kayseri Training and Research Hospital, who underwent gastric biopsy during endoscopy, were enrolled as the study group. The control group consisted of 47 age- and gender-matched patients who underwent endoscopy for dyspeptic complaints. The groups were compared regarding the presence of atrophic gastritis, H. pylori, lymphocytic gastritis, and intestinal metaplasia. Data were analyzed using IBM SPSS V23. Results: A total of 94 patients (47 CD, 47 dyspepsia) were included. Both groups comprised 20 male and 27 female patients. Atrophy frequency was 27.7% in the CD group and 17.0% in the dyspepsia group (p = 0.322). H. pylori positivity was 61.7% in the CD group and 74.5% in the dyspepsia group (p = 0.269). Lymphocytic gastritis was present in 12.8% of the CD group but was not detected in the control group (p = 0.011). No statistical difference was found in metaplasia frequency (p = 0.307). Serum vitamin B12 levels were below 200 pg/mL in 80% of CD patients. Conclusion: Gastric biopsy during endoscopy is recommended for celiac patients, particularly those with persistent anemia, dyspepsia, or B12 deficiency despite a gluten-free diet. While the frequencies of H. pylori infection and atrophic gastritis were similar to those in the control group, lymphocytic gastritis was significantly more common in CD patients. This finding underscores the importance of evaluating gastric mucosal changes to manage refractory symptoms and nutritional deficiencies effectively.