Hazarders of Smoking and <i>Helicobacter pylori</i>Infection on Gastric Mucosa among Egyptian Patients with Dyspepsia

Background: Smoking is hazardous to almost any organ in the body and has a harmful effect on the gastric mucosa. Objective: The main goal of this study was to evaluate the synergistic effect of smoking and H. pylori infection on gastric mucosal among dyspeptic Egyptian patients. Patients and Methods: A cross-sectional study was conducted among 240 consecutive patients with dyspepsia who underwent upper endoscopy and histopathological examination of gastric biopsies at Zagazig and Tanta University Hospital with H. pylori-positivity assessment by stool antigen and rapid urease test. Results: There were 60 smoker patients and 180 non-smoker patients. Erosive gastritis was more prevalent in smoker patients than non-smoker patients (46.7% versus 15.6%, p = 0.00). In H. pylori-positive patients (36.7% of all patients), smokers were more prevalent than non-smokers in the development of intestinal metaplasia (20% versus 0%, p = 0.003), erosive gastritis (80% versus 30%, p = 0.00), glandular atrophy (20% versus 0%, p = 0.003) and reactive gastropathy (20% versus 0%, p = 0.003). Conclusions: This study revealed that smoking may increase the prevalence of having gastric intestinal metaplasia, erosive gastritis, glandular atrophy and reactive gastropathy in H. pylori-positive Egyptian patients.