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Lack of Evidence for an Association Between Heliobacter pylori Infection and the Anorexia of Aging-Reply

Valery A. Portnoi, MD
Arch Intern Med. 1997;157(15):1772-1773. doi:10.1001/archinte.1997.00440360217032.
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I appreciated Howden's thorough and thoughtful analysis of the cases I reported suggesting a causal link between Heliobacter pylori infection and anorexia of aging.1 However, Howden's analysis does not refute the above contention, and it does not bring up the alternative clinical explanation for the reversal of anorexia and weight loss after treatment of the infection. The treatment, perhaps, was not adequate by the current standard, but the most effective treatment regimen of H pylori infection is just emerging.2

The limitation of the presented clinical observation based on only 3 case reports was acknowledged in the article. However, it took no more cases to describe the very old patients as dying from anorexia of aging as part of the naturalness of death. No reversible cause such as H pylori infection was sought by clinicians.3 Such an approach to the clinical problem solving in medical care for the


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