Is History of Adenotonsillectomy a Protective Factor for Helicobacter pylori Gastritis?

Introduction: Helicobacter pylori is a gram-negative bacillus seen worldwide, affecting around half of the world's population. It is reported that the adenotonsillar region is a colonisation area and plays a role in contamination. Based on this finding, there are some studies suggesting that history of previous adenotonsillectomy may be a protective factor for the colonization of H. pylori in the stomach. In this study, it was aimed to investigate whether the history of previous adenotonsillectomy was a protective factor for H. pylori gastritis. Materials and Methods: A total of 150 patients, including 75 patients with previous history of adenotonsillectomy and 75 patients without history of adenotonsillectomy, who were admitted to the gastroenterology clinic of Hitit University Corum Erol Olcok Training and Research Hospital for the first time with dyspeptic complaints and who underwent endoscopic biopsy of the antrum, were enrolled into the study. Endoscopic biopsy samples of the patients were stained histochemically with Hematoxylin Eosin (HE) and Giemsa to detect the presence of H. pylori. All cases were evaluated by the same pathologist according to the updated Sydney system. Results: The ages of the patients belonging to the group of previous history of adenotonsillectomy ranged from 22 to 80 years, with an average of 46.5 years (+/- 17.5 SD), and the ages of patients in the group of without history of adenotonsillectomy ranged from 24 to 75 years, with an average of 38.3 years (+/- 14.0 SD), and the age difference between these two groups was statistically significant. H. pylori gastritis was found in 52 (69%) of the 75 patients in the group of patients without history of adenotonsillectomy, and in 33 (44%) of the 75 patients in the group of patients with previous history of adenotonsillectomy, whose difference was statistically significant (p=0.021). When all patients in both groups were compared, H. pylori density average was 1.6 in the group of patients without history of adenotonsillectomy, whereas H. pylori density average was 0.8 in the group of patients with previous history of adenotonsillectomy, which was statistically significant (p=0.012). When H. pylori density in patients with H. pylori gastritis in both groups was compared, the mean value of the group of patients without history of adenotonsillectomy was 2.3, while the mean value of the group of patients with previous history of adenotonsillectomy was 1.8, which was statistically significant (p=0.022). Conclusion: Several studies have shown that the adenotonsillar region is a colonization site for H. pylori, using different methods. In our study, adenotonsillectomy was considered to play a protective role in reducing H. pylori spread and H. pylori gastritis, as it would prevent colonization in this region.