title: Does a relationship still exist between gastroesophageal reflux and Helicobacter pylori in patients with reflux symptoms?
abstract: BACKGROUND
  The nature of the relationship between Helicobacter pylori and reflux esophagitis (RE) is not fully understood. In addition, the effect of H. pylori eradication on RE and gastroesophageal reflux disease (GERD) is unclear. This study was designed to investigate the relationship between H. pylori infection and the grade of GERD in patients with reflux symptoms.
  
  
  METHODS
  Between January 2010 and July 2013, 184 consecutive patients with daily reflux symptoms for at least one year were evaluated at the ambulatory for functional esophageal disease, Tor Vergata University Hospital, Rome, Italy. All patients underwent a pretreatment evaluation, which included anamnesis, clinical examination, Esophagogastroduodenoscopy (EGDS) with biopsy, esophageal manometry and 24-hour pH-metry. All statistical elaborations were obtained using Statigraphies 5 plus for Window XP.
  
  
  RESULTS
  There was no statistical difference regarding Lower Esophageal Sphincter (LES) pressure between patients who were H. pylori-positive and H. Pylori-negative (19.2 ± 9.5 (range: 3.7 to 46.2) and 19.7 ± 11.0 (range: 2.6 to 61), respectively). Further, no significant difference was evidenced in esophageal wave length (mean value: 3.1 seconds in H. pylori-negative patients versus 3.2 seconds in H. pylori-positive patients) or in esophageal wave height (mean value: 72.2 ± 39.3 in H. pylori-negative patients versus 67.7 ± 28.4 in H. pylori-positive patients). We observed that hiatal hernia (P = 0.01), LES opening (P = 0.05), esophageal wave length (P = 0.01) and pathological reflux number (P = 0.05) were significantly related to the presence of esophagitis. However, H. pylori infection was not significantly related to the presence of reflux esophagitis.
  
  
  CONCLUSIONS
  Our clinical, endoscopic, manometric and pH-metric data shows no significant role of H. pylori infection in the development of GERD or in the pathogenesis of reflux esophagitis. However, current data do not provide sufficient evidence to define this relationship and further prospective large studies are needed.
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. grande@uniroma2.it.|Department of Surgery, University Hospital Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy. grande@uniroma2.it.
authors.forename: Michele
authors.initials: M
authors.lastname: Grande
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. giolimas06@yahoo.it.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Lisi
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. flaviodesanctis@libero.it.
authors.forename: Flavio
authors.initials: F
authors.lastname: De Sanctis
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. grande@uniroma2.it.
authors.forename: Simona
authors.initials: S
authors.lastname: Grande
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. saleias@libero.it.
authors.forename: Alessia
authors.initials: A
authors.lastname: Esser
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. michelacampanelli@live.it.
authors.forename: Michela
authors.initials: M
authors.lastname: Campanelli
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. valerio.balassone@gmail.com.
authors.forename: Valerio
authors.initials: V
authors.lastname: Balassone
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. giovanni.milito@virgilio.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Milito
authors.affiliation: Department of Experimental Science and Surgery, Policlinico "Tor Vergata", Viale Oxford, 81, 00133, Rome, Italy. massimo@inwind.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: Villa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016145:Endoscopy, Digestive System; D004942:Esophagitis, Peptic / Q000382:microbiology / Q000503:physiopathology*; D005260:Female; D005744:Gastric Acid / Q000502:physiology*; D005745:Gastric Acidity Determination; D005764:Gastroesophageal Reflux / Q000382:microbiology / Q000503:physiopathology*; D016481:Helicobacter Infections / Q000503:physiopathology*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008365:Manometry; D008875:Middle Aged; D055815:Young Adult