Increased reflux symptoms after calcium carbonate supplementation and successful anti-Helicobacter pylori treatment.
We used data from a randomized placebo-controlled clinical trial to examine the relationship between Helicobacter pylori and reflux symptoms in nonulcer dyspepsia patients randomly assigned anti-Helicobacter pylori triple therapy alone, calcium carbonate alone, or in combination with triple therapy, tetracycline, or placebo. We compared risk differences for posttreatment Helicobacter pylori status and increased reflux symptoms from crude, multivariable and stratified multivariable analyses. In crude analyses, 54% of subjects without Helicobacter pylori after-treatment reported an increase in reflux compared to 41% of those with persistent infection (risk difference = 13%; P = 0.07). Only subjects with multifocal atrophic gastritis assigned to calcium carbonate reported an increase in reflux symptoms more frequently when Helicobacter pylori was absent versus when it persisted (risk difference = 52%; P = 0.0001). Therefore, the interaction of calcium carbonate use, chronic multifocal atrophic gastritis, and the absence of Helicobacter pylori may increase reflux symptoms.
Fischbach
Lori A
LA
School of Public Health, University of Texas, Dallas Regional Campus, Dallas, Texas, USA.
Correa
Pelayo
P
Feldman
Mark
M
Fontham
Elizabeth
E
Priest
Elisa
E
Goodman
Karen J
KJ
Jain
Rajeev
R
D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage / Q000009:adverse effects; D000863:Antacids / Q000008:administration & dosage / Q000009:adverse effects*; D001729:Bismuth / Q000008:administration & dosage / Q000009:adverse effects; D002119:Calcium Carbonate / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005745:Gastric Acidity Determination; D005757:Gastritis, Atrophic / Q000150:complications* / Q000188:drug therapy; D005764:Gastroesophageal Reflux / Q000209:etiology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D012459:Salicylates / Q000008:administration & dosage / Q000009:adverse effects; D013752:Tetracycline / Q000008:administration & dosage / Q000009:adverse effects
D000863:Antacids; D009942:Organometallic Compounds; D012459:Salicylates; D008795:Metronidazole; C015715:bismuth subsalicylate; D000658:Amoxicillin; D013752:Tetracycline; D002119:Calcium Carbonate; D001729:Bismuth