Helicobacter pylori eradication does not worsen quality of life related to reflux symptoms: a prospective trial.
BACKGROUND
Concern has been raised that Helicobacter pylori therapy may lead to the development of gastro-oesophageal reflux disease. This prospective study was designed to assess reflux-related quality of life and the symptoms of gastro-oesophageal reflux disease in patients undergoing H. pylori therapy.


METHODS
Patients with a primary complaint of dyspepsia (upper abdominal pain or discomfort) and endoscopic biopsy positive for H. pylori received triple therapy for 2 weeks. A validated reflux-related quality of life questionnaire sensitive to change was given at baseline, 1 month and 6 months after therapy; symptoms were also recorded. A urea breath test was performed 1 month after the end of therapy; patients and investigators were blind to the results.


RESULTS
H. pylori was eradicated in 48 of 61 patients. The mean scores in cured patients for each of the five domains were comparable at baseline and 6 months after therapy: differences were - 0.23 to 0.13 (P > 0.20) on a scale of 1-7. The proportion of cured patients with a large decrease in quality of life (10-17% in the five domains) was similar to the proportion with a large increase (15-21%). Heartburn was present at baseline in 22 cured patients; at 6 months, it persisted in 13 and resolved in nine, whilst nine patients developed new heartburn.


CONCLUSIONS
A population of patients presenting with dyspepsia should have no overall increase or decrease in quality of life due to symptomatic gastro-oesophageal reflux disease in the 6 months after H. pylori therapy.
Laine
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Gastrointestinal Division, University of Southern California School of Medicine, 2025 Zonal Avenue, Los Angeles, CA 90033, USA. LLAINE@USC.EDU
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D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000897:Anti-Ulcer Agents / Q000008:administration & dosage; D001944:Breath Tests; D017291:Clarithromycin / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy* / Q000209:etiology / Q000382:microbiology; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000188:drug therapy*; D016481:Helicobacter Infections / Q000188:drug therapy*; D006801:Humans; D064747:Lansoprazole; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000008:administration & dosage / Q000031:analogs & derivatives*; D010406:Penicillins / Q000008:administration & dosage; D011446:Prospective Studies; D011788:Quality of Life; D014508:Urea / Q000032:analysis
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D010406:Penicillins; D064747:Lansoprazole; D000658:Amoxicillin; D014508:Urea; D017291:Clarithromycin; D009853:Omeprazole