Impact of alcohol consumption on helicobacter pylori infection in patients with functional dyspepsia: a prospective observational study

Abstract

Helicobacter pylori infection is a major cause of dyspeptic symptoms, but its association with alcohol consumption remains controversial. Few prospective studies have evaluated this relationship in patients with functional dyspepsia undergoing upper gastrointestinal endoscopy. This study assessed the association between alcohol consumption, measured using the WHO Alcohol Use Disorders Identification Test (AUDIT), and H. pylori infection. This 12-month single-centre prospective observational study included 340 adults with functional dyspepsia fulfilling Rome IV criteria. Using quota-based stratified enrolment, 170 alcohol consumers and 170 non-consumers were recruited. Alcohol exposure was classified by AUDIT score (0 = non-consumer; >0 = consumer). All participants underwent upper gastrointestinal endoscopy with gastric biopsy for rapid urease (CLO) testing and Giemsa-stained histopathology. H. pylori infection was defined by positivity on either test. The primary outcome was the prevalence of H. pylori infection among alcohol consumers and non-consumers, analysed using chi-square test and multivariable logistic regression. The overall prevalence of H. pylori infection was 67.6%. Infection was significantly lower among alcohol consumers than non-consumers (60.0% vs. 75.3%). Alcohol consumption was independently associated with lower odds of H. pylori infection (adjusted OR 0.49; 95% CI 0.31–0.78; p = 0.003). A significant inverse trend in infection prevalence was observed with increasing alcohol consumption frequency ( p < 0.001). In patients with functional dyspepsia, alcohol consumption was independently associated with a lower prevalence of H. pylori infection. These findings may contribute to risk stratification and clinical evaluation but do not imply a recommendation for alcohol consumption.