Effect of Helicobacter pylori eradication on gastroesophageal function.
BACKGROUND
To elucidate the cause of possible occurrence of reflux esophagitis after Helicobacter pylori eradication, gastric and esophageal function among H. pylori infected Japanese patients were evaluated both before and after eradication therapy.


METHODS
Nine H. pylori-positive patients were studied before and 6 months after successful H. pylori eradication. Studies included gastric emptying, esophageal manometry, gastric and esophageal pH monitoring as well as measuring serum levels of gastrin, pepsinogen I and pepsinogen II.


RESULTS
Helicobacter pylori eradication was associated with a significant change in serum gastrin and pepsinogen levels, consistent with the improvement in mucosal inflammation. There was no significant change in gastric emptying, fasting or postprandial lower esophageal sphincter (LES) pressure, esophageal primary peristaltic contractions, frequency of transient LES relaxation, or gastroesophageal reflux, as assessed by 24 h pH monitoring. The percent time of the gastric pH>4 at night decreased significantly. A 41-year-old male developed erosive gastroesophageal reflux disease (GERD) (Los Angeles Classification Grade A) after eradication. Physiological studies showed he had abnormal esophageal motility prior to H. pylori eradication.


CONCLUSIONS
With the exception of gastric pH at night, most patients did not experience a significant change in gastric or esophageal function after H. pylori eradication. Development of GERD post H. pylori eradication likely reflects an increase in the acidity of the refluxate superimposed on pre-existing abnormalities in gastroesophageal motility.
Tanaka
Izumi
I
Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan. izumitnk@sun.kpu-m.ac.jp
Tatsumi
Yoshihide
Y
Kodama
Tadashi
T
Kato
Keimei
K
Fujita
Shinya
S
Mitsufuji
Shoji
S
Kashima
Kei
K
D000328:Adult; D000368:Aged; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D016481:Helicobacter Infections / Q000503:physiopathology / Q000628:therapy*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000503:physiopathology