Rheumatoid arthritis (RA) is a chronic inflammatory disease of unknown aetiology affecting approximately 0.5–1% of the adult population worldwide.ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM–1", "itemData" : { "author" : [ { "dropping–particle" : "", "family" : "Kasper, D. L., Fauci, A. S., Hauser, S. L., Longo, D. L. 1., Jameson, J. L., & Loscalzo", "given" : "J", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" } ], "edition" : "19", "id" : "ITEM–1", "issued" : { "date–parts" : [ [ "2015" ] ] }, "publisher" : "New York: McGraw Hill Education.", "title" : "Rheumatoid Arthritis | Harrison‘s Principles of Internal Medicine, 19e | AccessMedicine | McGraw–Hill Medical", "type" : "book" }, "uris" : [ "http://www.mendeley.com/documents/?uuid=352019a3–e7a7–3800–b33d–b53413cde2a3" ] } ], "mendeley" : { "formattedCitation" : "^[1]", "plainTextFormattedCitation" : "[1]", "previouslyFormattedCitation" : "^[1]" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation–style–language/schema/raw/master/csl–citation.json" }^[1] Helicobacter Pylori HP infection, one of the most common chronic bacterial infections in the world, is linked to peptic ulcer disease (PUD) and is a key constituent of the human micro biome.ADDIN CSL_CITATION { "citationItems" : [ { "id" : "ITEM–1", "itemData" : { "DOI" : "10.1128/CMR.00054–05", "ISSN" : "0893–8512", "PMID" : "16847081", "abstract" : "Helicobacter pylori is the first formally recognized bacterial carcinogen and is one of the most successful human pathogens, as over half of the world‘s population is colonized with this gram–negative bacterium. Unless treated, colonization usually persists lifelong. H. pylori infection represents a key factor in the etiology of various gastrointestinal diseases, ranging from chronic active gastritis without clinical symptoms to peptic ulceration, gastric adenocarcinoma, and gastric mucosa–associated lymphoid tissue lymphoma. Disease outcome is the result of the complex interplay between the host and the bacterium. Host immune gene polymorphisms and gastric acid secretion largely determine the bacterium‘s ability to colonize a specific gastric niche. Bacterial virulence factors such as the cytotoxin–associated gene pathogenicity island–encoded protein CagA and the vacuolating cytotoxin VacA aid in this colonization of the gastric mucosa and subsequently seem to modulate the host‘s immune system. This review focuses on the microbiological, clinical, immunological, and biochemical aspects of the pathogenesis of H. pylori.", "author" : [ { "dropping–particle" : "", "family" : "Kusters", "given" : "J. G.", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Vliet", "given" : "A. H. M.", "non–dropping–particle" : "van", "parse–names" : false, "suffix" : "" }, { "dropping–particle" : "", "family" : "Kuipers", "given" : "E. J.", "non–dropping–particle" : "", "parse–names" : false, "suffix" : "" } ], "container–title" : "Clinical Microbiology Reviews", "id" : "ITEM–1", "issue" : "3", "issued" : { "date–parts" : [ [ "2006", "7", "1" ] ] }, "page" : "449–490", "title" : "Pathogenesis of Helicobacter pylori Infection", "type" : "article–journal", "volume" : "19" }, "uris" : [ "http://www.mendeley.com/documents/?uuid=2b30064e–65a4–320a–978f–2b917c0654c7" ] } ], "mendeley" : { "formattedCitation" : "^[5]", "plainTextFormattedCitation" : "[5]", "previouslyFormattedCitation" : "^[5]" }, "properties" : { "noteIndex" : 0 }, "schema" : "https://github.com/citation–style–language/schema/raw/master/csl–citation.json" }^[5] Aims and objectives: 1. To study the prevalence of Helicobacter pylori infection in confirmed cases of Rheumatoid Arthritis. 2. To study the relation between Helicobacter pylori infection and upper gastrointestinal symptoms (like nausea, vomiting, GERD and dyspepsia) in patients of RA receiving NSAID’s and DMARD’s therapy. Material and method: Inclusion Criteria Patient on DMARDs or NSAIDS having upper GI symptoms like nausea, vomiting, GERD and dyspepsia. 2. Willing to give informed consent. 3. Willing to undergo the requisite investigation.ExclusionCriteria:1.Uncooperative patients. 2. Not willing for endoscopy. 3. Contraindication of endoscopy. Results There was no statistically significant association between HP infection and the duration of GI symptoms (p = 0.850). There was a statistically significant association between HP positivity and endoscopic examination (p = 0.001). There was a statistically significant association between HP infection and nausea (p = 0.035), and GERD (p = 0.007). Statistical Analysis: The data was analysed using SPSS version 23 statistical software package. The statistical significance of continuous variables was determined by unpaired student test. Statistical significance of categorical variables was determined by Chi square test. The level of statistical significance was taken as p ≤ 0.05.Conclusion :.RA patients with refractory upper GI symptoms and taking DMARD’s and NSAID’s; should undergo endoscopy and HP testing. If positive, they should be treated with triple therapy.