I read with interest the recent article by Portnoi.1 Three elderly patients are described, all of whom had anorexia as part of a complex set of acute and chronic health problems. All had positive results of testing for Helicobacter pylori infection and received some form of treatment for the infection.
However, I caution the author and your readers about making any preliminary conclusions about an association between H pylori infection and the anorexia of aging. Helicobacter pylori infection is highly prevalent among elderly patients in the United States and elsewhere.2 Although Portnoi considers that this may reflect spread of infection through close contact, the bulk of evidence Suggests that most patients acquire this infection in childhood and remain infected lifelong.2 The patients described in this paper probably had longstanding infection with this bacterium.
An upper endoscopy in patient 1 showed gastritis and duodenitis. Helicobacter pylori infection is