Helicobacter pylori and gastroesophageal reflux disease.
BACKGROUND
The nature of the relationship between Helicobacter pylori and reflux oesophagitis is still not clear. To investigate the correlation between Helicobacter pylori infection and GERD taking into account endoscopic, pH-metric and histopathological data.


METHODS
Between January 2001 and January 2003 a prospective study was performed in 146 patients with GERD in order to determine the prevalence of Helicobacter pylori infection at gastric mucosa; further the value of the De Meester score endoscopic, manometric and pH-metric parameters, i.e. reflux episodes, pathological reflux episodes and extent of oesophageal acid exposure, of the patients with and without Helicobacter pylori infection were studied and statistically compared. Finally, univariate analysis of the above mentioned data were performed in order to evaluate the statistical correlation with reflux esophagitis.


RESULTS
There were no statistically significant differences between the two groups, HP infected and HP negative patients, regarding age, gender and type of symptoms. There was no statistical difference between the two groups regarding severity of symptoms and manometric parameters. The value of the De Meester score and the ph-metric parameters were similar in both groups. On univariate analysis, we observed that hiatal hernia (p = 0,01), LES size (p = 0,05), oesophageal wave length (p = 0,01) and pathological reflux number (p = 0,05) were significantly related to the presence of reflux oesophagitis.


CONCLUSIONS
Based on these findings, it seems that there is no significant evidence for an important role for H. pylori infection in the development of GERD and erosive esophagitis. Nevertheless, current data do not provide sufficient evidence to define the relationship between HP and GERD. Further assessments in prospective large studies are warranted.
Grande
Michele
M
Department of Surgery, University Hospital Tor Vergata, Rome, Italy. grande@uniroma2.it
Cadeddu
Federica
F
Villa
Massimo
M
Attinà
Grazia Maria
GM
Muzi
Marco Gallinella
MG
Nigro
Casimiro
C
Rulli
Francesco
F
Farinon
Attilio M
AM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004942:Esophagitis, Peptic / Q000175:diagnosis* / Q000382:microbiology*; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005764:Gastroesophageal Reflux / Q000175:diagnosis* / Q000382:microbiology*; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology; D016480:Helicobacter pylori; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult