SHM Converge Scientific Abstract ePoster Gallery-Gut- Brain Axis Depletion Caused by Helicobacter Pylori Infection: Unraveling Link to Severe Depression

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This case report describes a 53-year-old man with hypertension who presented with worsening altered mental status, fatigue, poor appetite, confusion, slowed responses, social withdrawal, and long-standing dyspepsia. Initial workup, including brain imaging and EEG, was unremarkable, though labs showed mild anemia. During hospitalization, he developed melena, dizziness, and encephalopathy requiring intubation. Upper endoscopy revealed a bleeding duodenal ulcer, which was treated with epinephrine injection for hemostasis.<br /><br />After extubation, the patient had dysphagia and persistent mood changes. A modified barium swallow ruled out vocal cord injury. Gastric biopsy confirmed Helicobacter pylori infection, and he was started on quadruple therapy. Psychiatry evaluated him and diagnosed catatonic mutism, for which lorazepam was initiated. Over the course of treatment, he completed 14 days of H. pylori therapy, and his dysphagia and energy level improved significantly. Lorazepam was later tapered, and he was discharged on fluoxetine and pantoprazole. Six weeks later, stool antigen testing confirmed eradication of H. pylori.<br /><br />The report highlights the possible role of H. pylori in disrupting the gut-brain axis. The infection may promote gut inflammation, increased intestinal permeability, microbiome changes, and altered production of neurotransmitters and short-chain fatty acids, potentially contributing to depression and other neuropsychiatric symptoms. The authors note that this case adds to growing evidence linking H. pylori with depression, catatonia, and other neurologic conditions, emphasizing the importance of recognizing gastrointestinal infection as a potential contributor to psychiatric and neurologic presentations.

Asset Subtitle

Angelin Raju

Meta Tag

Author List Angelin Raju, Scott M. Keeney, Sophia Dhanani

Category Clinical Vignettes

Concept Gut-Brain Axis

Concept Helicobacter pylori

Concept Gut Microbiota

Concept Duodenal Ulcer Bleeding

Concept Quadruple Therapy

Distinguished Non-Finalist

Presenter Organization Texas Health Resources Heb/Denton

Presenting Author Angelin Raju

Track Adult

Keywords

Helicobacter pylori

duodenal ulcer

melena

catatonic mutism

altered mental status

gut-brain axis

depression

encephalopathy

dysphagia

quadruple therapy

Gut-Brain Axis

Helicobacter pylori

Gut Microbiota

Duodenal Ulcer Bleeding

Quadruple Therapy