Review article: Helicobacter pylori and gastro-oesophageal reflux disease.
Epidemiological studies demonstrate a negative association between Helicobacter pylori infection and gastro-oesophageal reflux disease and its complications. This might represent a protective effect because of the tendency for H. pylori infection to lower gastric acid secretion with advancing age. However, studies of the effect of H. pylori eradication on gastro-oesophageal reflux disease have failed to show any worsening of gastro-oesophageal reflux disease symptoms. Several interactions between H. pylori and proton-pump inhibitor therapy used to treat gastro-oesophageal reflux disease need to be considered. Helicobacter pylori infection improves the control of gastric acidity by proton-pump inhibitors and this produces a small advantage in clinical control of reflux disease. The infection prevents rebound acid hypersecretion occurring when proton-pump inhibitor therapy is discontinued. However, concerns have been expressed that the body gastritis induced by proton-pump inhibitor therapy in H. pylori-infected subjects might increase the risk of gastric cancer. At present, it is unclear whether H. pylori should be eradicated in gastro-oesophageal reflux disease patients.
Delaney
B
B
Department of Primary Care, University of Birmingham, Birmingham, UK.
McColl
K
K
D004381:Duodenal Ulcer / Q000382:microbiology; D004415:Dyspepsia / Q000382:microbiology; D005744:Gastric Acid / Q000378:metabolism; D005756:Gastritis / Q000382:microbiology; D005764:Gastroesophageal Reflux / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D016481:Helicobacter Infections / Q000453:epidemiology / Q000503:physiopathology*; D016480:Helicobacter pylori; D006801:Humans; D054328:Proton Pump Inhibitors
D054328:Proton Pump Inhibitors