Helicobacter pylori infection associated with an increased incidence of cholelithiasis: A retrospective real‐world cohort study of 50 832 patients

Abstract Background and Aim Helicobacter pylori ( H. pylori ) infection is a bacterial disease of the stomach that has been associated with an increased incidence of cholelithiasis. While the updated German guideline emphasizes the relevance of H. pylori as a pathogen and recommends eradication therapy, systematic data on the association between H. pylori infection, its eradication, and the subsequent diagnosis of cholelithiasis in Germany are missing. Methods A total of 25 416 patients with and 25 416 propensity score‐matched individuals without H. pylori infection were identified from the Disease Analyzer database (IQVIA) between 2005 and 2021. A subsequent diagnosis of cholelithiasis was analyzed as a function of H. pylori infection as well as its eradication using Cox regression models. Results After 10 years of follow‐up, 8.0% versus 5.8% of patients with and without H. pylori infection were diagnosed with cholelithiasis ( P < 0.001). Regression analysis revealed a significant association between H. pylori infection and cholelithiasis (hazard ratio HR: 1.45; 95% confidence interval CI: 1.33–1.58), which was stronger in men (HR: 1.63; 95% CI: 1.41–1.90) than in women (HR: 1.36; 95% CI: 1.22–1.52). In terms of eradication therapy, both an eradicated H. pylori infection (HR: 1.48; 95% CI: 1.31–1.67) and a non‐eradicated H. pylori infection (HR: 1.41; 95% CI: 1.25–1.60) were associated with a subsequent diagnosis of cholelithiasis. Conclusion The present study reveals a strong association between H. pylori infection and a subsequent diagnosis of cholelithiasis in a large real‐world cohort from Germany. Eradication therapy was not associated with a reduced incidence of cholelithiasis in our cohort.