The incidence of reflux oesophagitis after eradication therapy for Helicobacter pylori.
BACKGROUND
Although several studies have indicated that Helicobacter pylori eradication develops reflux oesophagitis, others reported that its eradication had a beneficial effect on reflux symptoms. The results are still controversial.


OBJECTIVE
To study whether H. pylori eradication increases the occurrence rate of reflux oesophagitis in patients with peptic ulcers.


METHODS
One hundred and two consecutive patients who had peptic ulcers and were H. pylori-positive by C-urea breath testing were followed prospectively. They all received 1-week triple therapy and underwent endoscopy at 1-year intervals or when relapse of the peptic ulcer or occurrence of reflux oesophagitis was suspected.


RESULTS
Reflux oesophagitis developed in 32 (31.4%) out of 102 patients and they were of grade A (27 patients) and grade B (five patients) by the Los Angeles classification System. H. pylori infection was cured in 77 (75.5%) out of 102 patients. There was no significant difference in age (53.4+/-1.2 vs. 53.9+/-1.4 years, P = 0.43), gender (male/female, 29/3 vs. 53/17, P = 0.14), ulcer location (gastric/duodenal/both, 15/12/5 vs. 35/26/9, P = 0.97), H. pylori status (persistent/cured, 9/23 vs. 16/54, P = 0.57) or length of follow-up time (355+/-32 vs. 348+/-23 days, P = 0.30) between the 32 patients with reflux oesophagitis and the other 70 patients. Only the presence of hiatal hernia before therapy was significant for the prevalence of reflux oesophagitis by the log-rank test (P = 0.002), and the Cox proportional hazard models confirmed these findings (odds ratio, 3.46; 95% confidence interval, 1.64-7.30; P = 0.0012).


CONCLUSIONS
The eradication of H. pylori did not increase the prevalence of reflux oesophagitis, and only the presence of hiatal hernia before therapy was significantly related to the development of reflux oesophagitis.
Tsukada
Katsuhiko
K
Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Showamachi, Maebashi, Japan. katukada@topaz.ocn.ne.jp
Miyazaki
Tatsuya
T
Katoh
Hiroyuki
H
Fukuchi
Minoru
M
Fukai
Yasuyuki
Y
Kimura
Hitoshi
H
Sohda
Makoto
M
Yamada
Shuji
S
Toda
Naotaka
N
Motojima
Teiji
T
Kuwano
Hiroyuki
H
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004812:Epidemiologic Methods; D004942:Esophagitis, Peptic / Q000209:etiology*; D004945:Esophagoscopy; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006551:Hernia, Hiatal / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000382:microbiology
D000900:Anti-Bacterial Agents