Relationship between Helicobacter pylori infection and vomiting induced by gastrointestinal cancer chemotherapy

Intern Med J. 2017 Jul;47(7):792-797. doi: 10.1111/imj.13428.

Abstract

Background: Nausea and vomiting are the most common adverse reactions to chemotherapy.

Aim: To discuss the relationship between Helicobacter pylori and chemotherapy-induced nausea and vomiting (CINV).

Methods: A total of 112 patients with malignant tumours of the gastrointestinal tract was selected. Based on the 14C-urea breath test results, the patients were divided into H. pylori-positive (n = 59) and H. pylori-negative (n = 53) groups. Both groups received prophylactic antiemetic treatment during chemotherapy. The incidence of nausea and vomiting and their effects on the patients' life functions was recorded using the Multinational Association of Supportive Care in Cancer (MASCC) Antiemetic Tool (MAT) and the Functional Living Index Emesis (FLIE) from 0-120 h after chemotherapy. Records of the H. pylori-positive and H. pylori-negative groups were compared.

Results: The rates of nausea and vomiting remission were higher in the H. pylori -negative group than in the H. pylori -positive group. The proportions of no effect in daily life (NIDL) patients in the nausea and vomiting section were 73.4 and 75.5% in the H. pylori -negative group respectively. There was a higher proportion of NIDL patients in the H. pylori -negative group than in the H. pylori -positive group (P < 0.001, P = 0.046). A multivariate unconditional logistic regression analysis was performed, and the results showed that H. pylori infection was a factor affecting the nausea scores on the FLIE (odds ratio = 0.757, 95% confidence interval 0.597-0.960, P = 0.021).

Conclusion: H. pylori infection in patients with cancer may be a factor that increases CINV.

Keywords: FLIE; Helicobacter pylori; gastrointestinal tumour; nausea; vomiting.

MeSH terms

  • Aged
  • Antiemetics / therapeutic use
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Female
  • Gastrointestinal Neoplasms / drug therapy
  • Gastrointestinal Neoplasms / epidemiology*
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / epidemiology*
  • Helicobacter pylori* / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Nausea / chemically induced
  • Nausea / drug therapy
  • Nausea / epidemiology
  • Surveys and Questionnaires
  • Vomiting / chemically induced*
  • Vomiting / drug therapy
  • Vomiting / epidemiology*

Substances

  • Antiemetics
  • Antineoplastic Agents