Prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease: systematic review.
OBJECTIVE
To ascertain the prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease and its association with the disease.


METHODS
Systematic review of studies reporting the prevalence of H pylori in patients with and without gastro-oesophageal reflux disease.


METHODS
Four electronic databases, searched to November 2001, experts, pharmaceutical companies, and journals.


METHODS
Odds ratio for prevalence of H pylori in patients with gastro-oesophageal reflux disease.


RESULTS
20 studies were included. The pooled estimate of the odds ratio for prevalence of H pylori was 0.60 (95% confidence interval 0.47 to 0.78), indicating a lower prevalence in patients with gastro-oesophageal reflux disease. Substantial heterogeneity was observed between studies. Location seemed to be an important factor, with a much lower prevalence of H pylori in patients with gastro-oesophageal reflux disease in studies from the Far East, despite a higher overall prevalence of infection than western Europe and North America. Year of study was not a source of heterogeneity.


CONCLUSIONS
The prevalence of H pylori infection was significantly lower in patients with than without gastro-oesophageal reflux, with geographical location being a strong contributor to the heterogeneity between studies. Patients from the Far East with reflux disease had a lower prevalence of H pylori infection than patients from western Europe and North America, despite a higher prevalence in the general population.
Raghunath
Anan
A
Centre for Integrated Health Care Research, Wolfson Research Institute, University of Durham, Stockton on Tees TS17 6BH. raghu@nath.freeserve.co.uk
Hungin
A Pali S
AP
Wooff
David
D
Childs
Susan
S
D005764:Gastroesophageal Reflux / Q000453:epidemiology / Q000382:microbiology*; D014943:Global Health; D016481:Helicobacter Infections / Q000150:complications* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D016017:Odds Ratio; D015995:Prevalence