Causal Relationship of Helicobacter pylori With Iron-Deficiency Anemia or Failure of Iron Supplementation in Children

Background & aims We investigated Helicobacter pylori (H pylori)-infection as a cause of iron deficiency (ID) and iron-deficiency anemia (IDA) or treatment failure of iron supplementation. Methods We randomized 200 Hp-infected children (positive urea breath test) 2-5 years of age with IDA (hemoglobin level 8.3 mg/L) or ID (serum ferritin level 8.3 mg/L) to 1 of 4 regimens: 2-week anti-Hp therapy (amoxicillin, clarithromycin, and omeprazole) plus 90-day oral ferrous sulfate (anti-Hp plus iron), 2-week anti-Hp therapy alone, 90-day oral iron alone, or placebo. Sixty noninfected children with IDA received iron treatment as negative control. Results Hp-infected children receiving iron had significantly less frequent treatment failure compared with those with no iron in correcting IDA (11% [95% confidence interval (CI), 2%-20%]…