Impact of alcohol on gastric mucosa in a population with high prevalence of Helicobacter pylori


  • Sultan Nawahir Department of Gastroenterology, Chettinad Health City, Kelambakkam, Tamil Nadu, India
  • George Kurian Department of Gastroenterology, Pondicherry Institute of Medical Sciences, Pondicherry, India
  • Thomas Alexander Department of Gastroenterology, Pondicherry Institute of Medical Sciences, Pondicherry, India
  • Susy Kurian Department of Pathology, Pondicherry Institute of Medical Sciences, Pondicherry, India



Atrophic gastritis, Intestinal metaplasia, Gastric cancer


Background: The purpose of the study was to see whether chronic alcohol abuse had any effect on the gastric mucosa in a population already affected by a high prevalence of Helicobacter pylori.

Methods: 35 males with a history of chronic alcohol abuse were compared with 35 males who were abstinent or social drinkers. All subjects had complaints of dyspepsia. All subjects underwent endoscopy and targeted biopsies were taken from three specific sites in the stomach, namely body, antrum and incisura. Biopsies were studied to look for changes of atrophic gastritis and intestinal metaplasia. The presence or absences of H. pylori on the tissue biopsy were also recorded.

Results: Atrophic gastritis were only assessable in 24 alcoholic patients and 21 non-alcoholic patients due to the inadequacy of the depth of the biopsy. AG were found to be equally distributed in both the groups. 23 (64.9%) patients in the alcoholic group and 19(54.5%) in the control group had AG (OR-1.54, p=0.47). Intestinal metaplasia was seen in 10 (28.5%) alcoholic group and 12 (34.2) in the control group (OR-0.65, p=0.45). Of the 42 subjects detected to have AG, 16 (38.1%) had IM. However, IM were always associated with AG. In addition, H. pylori were not seen to be different in the two groups. H. pylori were positive in 18 (51.4%) alcoholic and14 (40%) non-alcoholic patients (p=0.33).

Conclusions: Chronic alcohol abuse doesn’t appear to have any major impact on the gastric mucosa in terms of producing premalignant lesions such as atrophic gastritis or intestinal metaplasia or enhancing the prevalence of H. pylori.


Kuepper-Nybelen J, Rothenbacher D, Brenner H. Relationship between lifetime alcohol consumption and Helicobacter pylori infection. Ann Epidemiol. 2005;15(8):607-13.

Watanabe Y, Ozasa K, Higashi A, Hayashi K, Mizuno S, Mukai M, et al. Helicobacter pylori infection and atrophic gastritis: A case-control study in a rural town of Japan. J Clin Gastroenterol. 1997; 25(1):391-4.

Prasad S, Mathan M, Chandy G, Rajan DP, Venkateswaran S, Ramakrishna BS, et al. Prevalence of Helicobacter pylori in southern Indian controls and patients with gastroduodenal disease. J Gastroenterol Hepatol. 1994;9(5):501-6.

Park YH, Kim N. Review of atrophic gastritis and intestinal metaplasia as a premalignant lesion of gastric cancer. J Cancer Prev. 2015;20(1):25-40.

Haas SL, Ye W, Löhr JM. Alcohol consumption and digestive tract cancer. Curr Opin Clin Nutr Metab Care. 2012;15(5):457-67.

Boffetta P, Hashibe M. Alcohol and cancer. Lancet Oncol. 2006;7(2):149-56.

Bagnardi V, Blangiardo M, La Vecchia C, Corrao G. A meta-analysis of alcohol drinking and cancer risk. Br J Cancer. 2001;85(11):1700-5.

Jarl J, Heckley G, Brummer J, Gerdtham UG. Time characteristics of the effect of alcohol cessation on the risk of stomach cancer--a meta-analysis. BMC Public Health. 2013;13:600.

Sokic-Milutinovic A, Alempijevic T, Milosavljevic T. Role of Helicobacter pylori infection in gastric carcinogenesis: Current knowledge and future directions. World J Gastroenterol. 2015;21(41): 11654-72.

Tovey FI, Hobsley M, Holton J. Helicobacter pylori virulence factors in duodenal ulceration: A primary cause or a secondary infection causing chronicity. World J Gastroenterol. 2006;12(1):6-9.

Misra V, Pandey R, Misra SP, Dwivedi M. Helicobacter pylori and gastric cancer: Indian enigma. World J Gastroenterol. 2014;20(6):1503-9.

Dikshit RP, Mathur G, Mhatre S, Yeole BB. Epidemiological review of gastric cancer in India. Indian J Med Paediatr Oncol. 2011;32(1):3.

Yoshida T, Kato J, Inoue I, Yoshimura N, Deguchi H, Mukoubayashi C, et al. Cancer development based on chronic active gastritis and resulting gastric atrophy as assessed by serum levels of pepsinogen and Helicobacter pylori antibody titer. Int J Cancer. 2014;134(6):1445-57.

Das SK, Balakrishnan V, Vasudevan DM. Alcohol: its health and social impact in India. Natl Med J India. 2006;19(2):94-9.

Kim S, Rifkin S, John SM, Jacob KS. Nature, prevalence and risk factors of alcohol use in an urban slum of Southern India. Natl Med J India. 2013;26(4):203-9.

Alcohol. WHO. Available at: mediacentre/factsheets/fs349/en/. Accessed on 20 February 2021.

Kuepper-Nybelen J, Rothenbacher D, Brenner H. Relationship between lifetime alcohol consumption and Helicobacter pylori infection. Ann Epidemiol. 2005;15(8):607-13.

Brenner H, Bode G, Adler G, Hoffmeister A, Koenig W, Rothenbacher D. Alcohol as a gastric disinfectant? The complex relationship between alcohol consumption and current Helicobacter pylori infection. Epidemiol. 2001;12(2):209-14.

Gikas A, Triantafillidis JK, Apostolidis N, Mallas E, Peros G, Androulakis G. Relationship of smoking and coffee and alcohol consumption with seroconversion to Helicobacter pylori: a longitudinal study in hospital workers. J Gastroenterol Hepatol. 2004;19(8):927-33.

Adami H-O, McLaughlin JK, Hsing AW, Wolk A, Ekbom A, Holmberg L, et al. Alcoholism and cancer risk: a population-based cohort study. Cancer Causes and Control. 1992;3(5):419-25.






Original Research Articles