Relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection: cross sectional study

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Abstract
Objective: To assess the relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection. Design: Cross sectional study of patients attending a general practitioner. Active H pylori infection was measured by the 13C-urea breath test and detailed quantitative information on smoking and on alcohol and coffee consumption was obtained by a standardised self administered questionnaire. Setting: One general practice in Germany. Subjects: 447 patients aged 15–79 who had not had peptic ulcer disease or treatment for H pylori infection. Main outcome measures: Prevalence of H pylori infection according to smoking and alcohol and coffee consumption. Results: 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 ≥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). Conclusion: These results suggest a protective effect of alcohol consumption against active infection with H pylori and an opposite effect of coffee consumption. Although H pylori infection is commonly acquired during childhood, active infection may be acquired and eliminated throughout adulthood This study of patients in a general practice found no significant relation between smoking and active H pylori infection Drinking alcohol seemed to protect against active H pylori infection This protective effect was dose dependent and similar for beer and wine Drinking coffee was associated with an increased prevalence of active H pylori infection The protective effect of alcohol on active H pylori infection may be related to its antimicrobial effects