The effect of Helicobacter pylori eradication on gastro-oesophageal reflux.
BACKGROUND
Increased prevalence of oesophagitis has been reported following eradication of Helicobacter pylori. We hypothesized that H. pylori eradication might increase gastro-oesophageal acid reflux in patients with reflux oesophagitis.


METHODS
Twenty-five consecutive patients (13 male, 12 female) with H. pylori infection and reflux oesophagitis grade I (22 patients) or II (three patients) were enrolled; mean age 49.9 (range 33-75) years. Twenty-four hour intra-oesophageal pH recording was performed before and 12 weeks after eradication of H. pylori, which was achieved using bismuth subnitrate suspension 150 mg q.d.s., oxytetracycline 500 mg q.d.s. and metronidazole 400 mg t.d.s. for 10 days. Eradication was confirmed by 14C-urea breath test 12 weeks after completion of treatment. The patients did not receive acid-suppressive medication.


RESULTS
All patients had abnormal gastro-oesophageal reflux before anti-H. pylori treatment. After treatment, there was no significant change in the percentage of total time oesophageal pH < 4 (P=0.46) in the 23 patients in whom the infection had been cured. Nine of the cured patients had increased acid exposure, whereas 14 had decreased acid exposure. No significant change in reflux symptom scores was found. There was no relationship between change in acid exposure and symptom improvement.


CONCLUSIONS
Twelve weeks after H. pylori eradication there was no consistent change in gastro-oesophageal acid reflux in patients with mild or moderate reflux oesophagitis.
Tefera
S
S
Division of Gastroenterology, Department of Medicine, Haukeland Hospital, University of Bergen, Norway. stef@haukeland.no
Hatlebakk
J G
JG
Berstad
A
A
D000328:Adult; D000368:Aged; D000863:Antacids / Q000494:pharmacology* / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001729:Bismuth / Q000494:pharmacology* / Q000627:therapeutic use; D001944:Breath Tests; D004359:Drug Therapy, Combination; D004941:Esophagitis / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000378:metabolism* / Q000473:pathology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008795:Metronidazole / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D010118:Oxytetracycline / Q000494:pharmacology* / Q000627:therapeutic use; D012720:Severity of Illness Index
D000863:Antacids; D000900:Anti-Bacterial Agents; D008795:Metronidazole; C010804:bismuth subnitrate; D001729:Bismuth; D010118:Oxytetracycline