Helicobacter pylori (H. pylori) is a type of bacteria responsible for widespread infection with more than 50% of the world’s population infected, although 80% of those infected have no symptoms. Infection with H. pylori has been considered as a public health problem worldwide and more prevalent in developing than the developed countries. H. pylori infection has been associated with manymicronutrient deficiencies. Scientists have detected H. pylori in more than half of patients suffering from pernicious anemia, even in individuals without gastritis or other digestive problems because of untreated vitamin B12 deficiency. Some studies suggested that pernicious anemia may represent the final phase of a process that begins with H. pyloriassociated gastritis and evolves through progressive levels of atrophy until the parietal cell mass is completely lost. The colonization of gastric mucosa with H pylori includes chronic local and systemic immune response. However, pernicious anemia is the result of an autoimmune disease in which antibodies attack the parietal cells of the stomach, almost completely blocking the release of IF as a result. This hindered IF release prevents the formation of the IF-B12 complex, subsequently impairing B12 absorption. The primary aim of study was to detect whether H pyloriinfection in the gastric mucosa is responsible for vitamin B12 deficiency since as early detection and eradication of Helicobacter pylorican prevent to development of complications as gastritis, gastric, duodenal ulcer and megaloblastic anemia.
Two hundred sixty seven randomly selected eligible participants with suggested symptoms of peptic ulcer disease in Serdang Kuala Lumpur. About 0.2 g of stool was collected into a sterile container. All stool samples were frozen at-20°C until tested for H. pylori antigen by HpSAg kit (DRG-Germany). Methods of analysis followed the manufacturer instruction. The HpSA negative (-) patients were excluded while HpSA positive (+) patients were further evaluated for urine vitamin B 12 level. The first urine of the day (mid-stream) was collected directly into a sterile container. Urine samples were centrifuged to remove particulate matter, frozen at <-20°C until tested for vitamin B12 by human vitamin B12 ELISA kit.