Helicobacter pylori and its interaction with risk factors for chronic disease

We are not quite ready to recommend green tea and saki to the exclusion of coffee

In this issue Brenner and colleagues document the effects of lifestyle on Helicobacter pylori infection in 447 patients in a German rural practice (p 1489).1 They found that the H pylori infection rate appeared to be reduced by alcohol consumption (≥3 cups per day), and non-significantly increased by smoking. In the past, when idiopathic gastric hyperacidity was considered to be the chief cause of dyspeptic symptoms, smoking, coffee, and alcohol were often implicated as exacerbating the condition and advice given to eliminate these habits. Increasingly since 1984, however, when Warren and Marshall hypothesised that campylobacter-like organisms were the cause of peptic ulcer disease,2 there has been a need to re-evaluate the role of these traditional risk factors. This need has been addressed by Brenner et al with some seemingly unexpected results.

There are reasons why alcohol, coffee, and smoking might have little effect on, or even increase, the hostility of the gastric environment to H …