Objective:

To investigate whether Helicobacter pylori (HP) infection is associated with colonic diverticulosis in an asymptomatic Austrian screening cohort.

Approach:

• Study Design: Retrospective observational study of 5646 asymptomatic adults undergoing screening colonoscopy with concurrent oesophagogastroduodenoscopy from 2007 to 2020.
• Data Collection: Diverticulosis classified endoscopically; HP status determined histologically from gastric biopsies.
• Statistical Analysis: Multivariable logistic regression adjusted for metabolic, sociodemographic, and lifestyle factors.

Key Findings:

• Diverticulosis was present in 37% of participants and HP infection in 19%.
• No association found between HP infection and diverticulosis in univariable (OR 1.01, p=0.935) or fully adjusted analysis (OR 0.86, p=0.078).
• Subgroup analyses showed consistent null results across diverticular distribution and risk factors.
• In a longitudinal subset, diverticulosis prevalence at follow-up did not differ by baseline HP status (63.9% vs 62.1%; p=0.749).

Interpretation:

HP infection was not associated with colonic diverticulosis across subtypes or risk strata.

Limitations:

• The study is retrospective and conducted in a single center, which may limit generalizability.
• The population was asymptomatic, which may not reflect the broader population with diverticulosis.

Conclusion:

HP infection may be regarded as a potential confounder or marker of broader host, socioeconomic, or healthcare-related factors in future studies.