title: Patients with established gastro-esophageal reflux disease might benefit fromHelicobacter pylorieradication.
abstract: BACKGROUND
  The aim of this study was to investigate the effect ofHelicobacter pylori(H. pylori) eradication in selectedH. pylori-positive patients with a primary diagnosis of gastro-esophageal reflux disease (GERD) by using the 3-h postprandial esophageal pH monitoring.
  
  
  METHODS
  We recruited patients with erosive esophagitis at endoscopy andH. pyloriinfection at histology, successfully cured following eradication therapy; the selectedH. pylori-positive patients had weekly reflux symptoms for at least six months and endoscopically established Grade A or B esophagitis. Twenty-nine eligible patients were initially subjected to esophageal manometry and ambulatory 3-h postprandial esophageal pH monitoring. All patients receivedH. pyloritriple eradication therapy accompanied by successfulH. pylorieradication. After successful eradication ofH. pylori(confirmed by13C urea breath test), a second manometry and 3-h postprandial esophageal pH monitoring were introduced to assess the results of eradication therapy, after a 3-month post-treatment period.
  
  
  RESULTS
  All 29 selectedH. pylori-positive patients became negative due to successfulH. pylorieradication, evaluated by13C urea breath test after a 4-week post-treatment period. Post-eradication, 62.1% patients showed similar manometric pattern at baseline; 17.2% showed improvement; 17.2% normalization; and 3.4% deterioration of the manometric patterns. The DeMeester symptom scoring in the 3-h postprandial ambulatory esophageal pH monitoring was improved after eradication ofH. pylori(median 47.47 vs. 22.00, Wilcoxon's singed rank; P=0.016). On comparing the pH monitoring studies for each patient at baseline and post-eradication period, 82.8% patients showed improvement and 17.2% deterioration of the DeMeester score.
  
  
  CONCLUSIONS
  By using 3-h postprandial esophageal pH monitoring, this study showed, for the first time, thatH. pylorieradication may positively influence GERD symptoms. Large-scale controlled relative studies are warranted to confirm these findings.
authors.affiliation: Medical School Democritus University of Thrace, Alexandroupolis (John M. Moschos, George Kouklakis, Stergios Vradelis, Petros Zezos, Michael Pitiakoudis), Greece.
authors.forename: John M
authors.initials: JM
authors.lastname: Moschos
authors.affiliation: Medical School Democritus University of Thrace, Alexandroupolis (John M. Moschos, George Kouklakis, Stergios Vradelis, Petros Zezos, Michael Pitiakoudis), Greece.
authors.forename: George
authors.initials: G
authors.lastname: Kouklakis
authors.affiliation: Medical School Democritus University of Thrace, Alexandroupolis (John M. Moschos, George Kouklakis, Stergios Vradelis, Petros Zezos, Michael Pitiakoudis), Greece.
authors.forename: Stergios
authors.initials: S
authors.lastname: Vradelis
authors.affiliation: Medical School Democritus University of Thrace, Alexandroupolis (John M. Moschos, George Kouklakis, Stergios Vradelis, Petros Zezos, Michael Pitiakoudis), Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Zezos
authors.affiliation: Medical School Democritus University of Thrace, Alexandroupolis (John M. Moschos, George Kouklakis, Stergios Vradelis, Petros Zezos, Michael Pitiakoudis), Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Pitiakoudis
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki (Dimitrios Chatzopoulos, Christos Zavos, Jannis Kountouras), Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Chatzopoulos
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki (Dimitrios Chatzopoulos, Christos Zavos, Jannis Kountouras), Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Zavos
authors.affiliation: Department of Medicine, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki (Dimitrios Chatzopoulos, Christos Zavos, Jannis Kountouras), Greece.
authors.forename: Jannis
authors.initials: J
authors.lastname: Kountouras
keywords: DeMeester symptom scoring; Helicobacter pylori; esophageal pH monitoring; gastro-esophageal reflux disease