Colorectal polyp risk in the context of gastric pathology: The roles of intestinal metaplasia and Helicobacter Pylori

Vural Argin; Omer Ozduman; Ahmet Orhan Sunar; Mursit Dincer; Aziz Serkan Senger; Selcuk  Gulmez; Orhan Uzun; Mustafa Duman; Erdal Polat

doi:10.5281/zenodo.17282517

Authors

Vural Argin Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0002-6526-1821
Omer Ozduman Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0002-6527-506X
Ahmet Orhan Sunar Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0001-5564-6923
Mursit Dincer Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0002-1930-0383
Aziz Serkan Senger Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0003-0981-0141
Selcuk Gulmez Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0001-9719-1904
Orhan Uzun Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0001-6550-0936
Mustafa Duman Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0002-0276-0543
Erdal Polat Gastrointestinal Surgery Clinic, University of Health Sciences, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital, Istanbul, Türkiye https://orcid.org/0000-0002-9463-9846

DOI:

https://doi.org/10.5281/zenodo.17282517

Keywords:

Helicobacter pylori, Intestinal metaplasia, Colorectal polyp, Risk factors

Abstract

Objective: The role of Helicobacter pylori (H. pylori) infection and intestinal metaplasia (IM) in colorectal neoplasia remains unclear. While H. pylori is a recognized cause of upper gastrointestinal disease, its effect on the colorectum is controversial. IM, often arising from chronic gastritis, may reflect systemic mucosal changes with potential relevance to colorectal pathology. Our aim was to investigate the association between H. pylori, IM, and colorectal polyp development.

Materials and methods: In this retrospective cross-sectional study, 626 patients who underwent both upper gastrointestinal endoscopy and colonoscopy were evaluated. Gastric biopsies were examined histologically for H. pylori and IM, and colorectal polyps were assessed for size, location, and histology. Logistic regression was used to identify factors associated with polyp presence.

Results: Colorectal polyps were found in 29.1% of patients, most being tubular adenomas <1 cm. H. pylori infection was not associated with polyps (p=0.979), whereas IM was strongly associated (44.6% vs. 22.8%, p<0.001) and remained significant in multivariate analysis (OR=2.29, 95% CI: 1.60–3.28, p<0.001).

Conclusion: IM is significantly associated with colorectal polyp presence and may serve as a marker to prioritize colonoscopic screening, particularly in intermediate-risk populations. Further prospective studies are warranted to confirm these findings and explore underlying mechanisms.

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