Helicobacter pylori Colonization in Biopsies of the Adenotonsillectomy Specimens

Problem statement: Helicobacter pylori (H. pylori) is a microaerophilic, gram negative bacillus, which can cause peptic ulcer and gastric cancer. Recurrent infection with this agent is considered as one of the reasons for failure of peptic ulcer treatment. Some studies have reported colonization of H. pylori in dental plaques, tonsils and adenoid tissues. Therefore oral cavity could be the source of H. pylori and it might be the reason for unsuccessful eradication. Approach: In this cross sectional study, 95 patients with the average age of 12.1±7.5 years undergoing adenotonsillectomy were chosen consecutively. Intra-operatively a 2 mm section of the tonsils were removed and investigated for H. pylori by Rapid Urease Test (RUT). Post-operatively the removed tonsils were stained by hematoxylin-eosin (H and E) and Gimsa for direct investigation of H. pylori bacterium. Serum samples of the patients were also tested for the presence of H. pylori IgG antibody. Results: Overall 70 patients (73.7%) had positive anti- H. pylori IgG antibody in their sera. The results of RUT on adeno-tonsils showed that 42.1% of the specimens were positive for H. pylori. In histology examination, 9 patients (9.5%) were positive for the presence of bacterium. Conclusion: Based on our findings it seems that tonsils and adenoid tissues are the candidate places for the growth of H. pylori. Further studies about the role of tonsillar colonization of H. pylori in re-infection after treatment are recommended.