Improvement of reflux symptoms 3 years after cure of Helicobacter pylori infection: a case-controlled study in the Japanese population.
BACKGROUND
Development of reflux esophagitis is one of the adverse effects that cause concern in relation to curative treatment of Helicobacter pylori infection. However, recent studies present a rather negative association between curative treatment and development of reflux esophagitis or reflux symptoms. Therefore, this issue has remained controversial. Accordingly, we investigated the long-term adverse effects of H. pylori eradication treatment in special reference to development of reflux symptoms.


METHODS
We conducted a case controlled study by mailing structured questionnaires on past (before curative treatment or 3 years previously) and current status. A case was an endoscopically confirmed peptic ulcer patient with confirmed cure of the infection after eradication treatment 3 years previously and a control was one who had not undergone the eradication treatment during the same period. We studied 241 pairs who matched for age, gender, and type of ulcer disease (GU, DU or GDU). Of these pairs, 81.3% were male and the mean age was 52.6 +/- 9.6 year (range 23-76).


RESULTS
The rates of patients with improved reflux symptoms in the case and control groups were 65.4% and 30.4%, respectively, with the rate being significantly greater in the case group. On the contrary, the rates of those with worsened reflux symptoms were similar (5.1% and 7.6%). Regarding general events, the rate of patients with decreased frequency of hospital visits and of those who regularly used antiacid medications were significantly decreased in the case group. Furthermore, the case group experienced significantly fewer hospital admissions for various diseases in this 3-year period. However, a significantly greater number of case group patients than control subjects gained weight.


CONCLUSIONS
Reflux symptoms as well as general well-being were significantly improved after cure of H. pylori infection.
Miwa
Hiroto
H
Department of Gastroenterology, Juntendo University, School of Medicine, Tokyo, Japan.
Sugiyama
Yuriko
Y
Ohkusa
Toshifumi
T
Kurosawa
Akihiko
A
Hojo
Mariko
M
Yokoyama
Tetsuji
T
Hamada
Tsutomu
T
Basyuda
Hisashi
H
Sato
Nobuhiro
N
D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D017291:Clarithromycin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004942:Esophagitis, Peptic / Q000503:physiopathology*; D005260:Female; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054328:Proton Pump Inhibitors; D017494:Proton Pumps / Q000627:therapeutic use; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D000900:Anti-Bacterial Agents; D054328:Proton Pump Inhibitors; D017494:Proton Pumps; D000658:Amoxicillin; D017291:Clarithromycin