title: Randomised controlled trial of effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux: Bristol helicobacter project.
abstract: OBJECTIVE
  To investigate the effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux.
  
  
  METHODS
  Cross sectional study, followed by a randomised placebo controlled trial.
  
  
  METHODS
  Seven general practices in Bristol, England.
  
  
  METHODS
  10,537 people, aged 20-59 years, with and without H pylori infection (determined by the (13)C-urea breath test).
  
  
  METHODS
  Prevalence of heartburn and gastro-oesophageal acid reflux at baseline and two years after treatment to eradicate H pylori infection.
  
  
  RESULTS
  At baseline, H pylori infection was associated with increased prevalence of heartburn (odds ratio 1.14, 95% confidence interval 1.05 to 1.23) but not reflux (1.05, 0.97 to 1.14). In participants with H pylori infection, active treatment had no effect on the overall prevalence of heartburn (0.99, 0.88 to 1.12) or reflux (1.04, 0.91 to 1.19) and did not improve pre-existing symptoms of heartburn or reflux.
  
  
  CONCLUSIONS
  H pylori infection is associated with a slightly increased prevalence of heartburn but not reflux. Treatment to eradicate H pylori has no net benefit in patients with heartburn or gastro-oesophageal reflux.
authors.affiliation: Frenchay Hospital, North Bristol NHS Trust, Bristol BS16 1LE. richard.harvey1@virgin.net
authors.forename: Richard F
authors.initials: RF
authors.lastname: Harvey
authors.forename: J Athene
authors.initials: JA
authors.lastname: Lane
authors.forename: Liam J
authors.initials: LJ
authors.lastname: Murray
authors.forename: Ian M
authors.initials: IM
authors.lastname: Harvey
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Donovan
authors.forename: Prakash
authors.initials: P
authors.lastname: Nair
mesh_terms: D000328:Adult; D001944:Breath Tests; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005764:Gastroesophageal Reflux / Q000382:microbiology* / Q000517:prevention & control; D006356:Heartburn / Q000382:microbiology* / Q000517:prevention & control; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014508:Urea / Q000032:analysis
chemical_list: D014508:Urea