title: Impact of Helicobacter pylori infection on histological changes in non-erosive reflux disease.
abstract: OBJECTIVE
  The evidence for an association between Helicobacter pylori (H pylori) and gastroesophageal reflux disease, either in non- erosive (NERD) or erosive esophagitis (ERD) remains uncertain. The available data on the histological changes in NERD and the effect on H pylori infection on them are elusive. The aim of this study therefore was to prospectively evaluate the histological findings and the impact of H pylori infection on a group of symptomatic patients with NERD.
  
  
  METHODS
  Fifty consecutive patients were prospectively evaluated for symptoms compatible with GORD. In all cases, routine endoscopy and lugol directed biopsies were performed and assessed histologically in a blinded manner.
  
  
  RESULTS
  The overall prevalence of H pylori infection was 70%. Twenty-nine patients out of 50 (58%) were NERD patients. No statistical significance was observed between the H pylori status and NERD. The remaining 21 (42%) were diagnosed as follows: 13 (26%), 6 (12%), 2(4%) with esophagitis grade A, B and C respectively. A statistically significant correlation was observed between the H pylori+ and esophagitis grade A, as well as between H pylori- and grade B. Biopsies from 2 patients were not included because of insufficient materials. Histologically, a basal zone hyperplasia was found in 47 (97.91%) patients, alterations of glycogen content in 47 (97.91%), papillae elongation in 33 (68.75%), blood vessels dilatation in 35(72.91%), chronic inflammation in 21 (43.75%), infiltration with eosinophils, neutophils and T-lymphocytes in 4 (8.33%), 6 (12.5%) and 39 (81.25%) respectively. No correlation was observed between the H pylori status and the histological parameters studied either in NERD or GERD.
  
  
  CONCLUSIONS
  Histological assessment can not differentiate symptomatic patients with erosive versus non-erosive reflux disease. Moreover, H pylori infection may not act as an important factor in patients with NERD.
authors.affiliation: Gastroenterologist, Lecturer in Internal Medicine, Chrisostomou Smirnis 8, 68100 Alexandroupolis, Greece.
authors.forename: Anthie
authors.initials: A
authors.lastname: Gatopoulou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Mimidis
authors.forename: Alexandra
authors.initials: A
authors.lastname: Giatromanolaki
authors.forename: Alexandros
authors.initials: A
authors.lastname: Polichronidis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Lirantzopoulos
authors.forename: Efthimios
authors.initials: E
authors.lastname: Sivridis
authors.forename: George
authors.initials: G
authors.lastname: Minopoulos
mesh_terms: D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D004942:Esophagitis, Peptic / Q000382:microbiology / Q000473:pathology*; D005260:Female; D005764:Gastroesophageal Reflux / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000150:complications / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D006965:Hyperplasia; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies