I just found this study on the internet that shows a link between a
positive test for h pylori and iron deficiency.  I wonder if the H Pylori
should now be treated in order to see if her iron/blood tests improve.  
Af the very least, I'll inform the doctor or his pa (since it's almost
impossible to get the gastro guy on the phone).  Here's the link and the
study:

http://tinyurl.com/4gwnf

Iron-Deficiency Anemia Linked to Bacteria

By Peggy Peck
WebMD Medical News  


Nov. 1, 1999 (Cleveland) -- A team of Italian researchers has found that
a bacteria, Helicobactor pylori, may play a role in some cases of iron-
deficiency anemia. The researchers, writing in the Nov. 2 issue of the
Annals of Internal Medicine, suggest that eradicating H. pylori with
antibiotics can lead to recovery from anemia and eliminate the need for
iron supplementation.

Bruno Annibale, MD, and colleagues from the Policlinico Unversitario
Umberto I in Rome, analyzed 30 patients with iron-deficiency anemia to
try to find out what was causing the condition. H. pylori infection and
stomach inflammation were discovered after the patients were examined.
The patients were treated with three medications -- Prilosec
(omeprazole), Amoxil (amoxicillin), and Flagyl (metronidazole) -- to
knock out the bacterial infection.

At six months after treatment for H. pylori, 75% of the patients had
recovered from the anemia and after one year, the anemia was gone in 90%
of the patients.

In 80% of the patients the H. pylori bacteria was causing inflammation in
a very large area of the stomach. Annibale's team writes that such
extensive inflammation could be a characteristic particular to patients
with iron-deficiency anemia linked to H. pylori infection.

Although elimination of infection appears to reverse anemia, it is not a
rapid recovery and the build-up of iron reserves is slow. In these
patients it took 1-2 years to increase the storage of iron.

According to Annibale and colleagues, one explanation for the slow
recovery of iron reserves may be that most of the patients were younger
women. Blood loss during the menstrual cycle is the most common cause of
anemia in premenopausal women. H. pylori infection may therefore
"unbalance an already unstable equilibrium and lead to the development of
iron deficiency anemia," they write.

The researchers also note that H. pylori is known to reduce the amount of
vitamin C in the stomach, which can prevent iron absorption. In addition,
they speculate that since H. pylori needs iron to grow, it could deplete
iron in the stomach.

Within the last five years the treatment of peptic ulcer disease has
undergone a revolution as physicians have learned that it is often caused
by H. pylori and can be treated with antibiotics.

Here's another report on this study:

http://www.turner-white.com/memberfile.php?PubCode=jcom_jan00_iron.pdf