title: [Helicobacter pylori eradication and gastroesophageal reflux disease: a Meta-analysis].
abstract: OBJECTIVE
  To systematically evaluate whether eradication of Helicobacter pylori (H.pylori) is associated with the development of endoscopic gastroesophageal reflux disease (GERD) and reflux symptoms.
  
  
  METHODS
  PubMed, CENTRAL, Embase, CNKI and Wanfang Database from April 1978 to April 2015 were retrieved to collect the randomized controlled trials (RCTs) comparing the incidence of reflux symptoms or reflux esophagitis in patients receiving H. pylori eradication treatment and those without treatment. The quality of trials was evaluated by the Cochrane Collaboration's tool for assessing risk of bias and Jadad scoring. A Meta-analysis was conducted by using RevMan 5.20 software.
  
  
  RESULTS
  Twenty RCTs involving 6 575 cases were included. Meta-analysis showed that: (1) There was a positive link between H. pylori eradication and endoscopic reflux esophagitis. The diagnostic rate of endoscopic reflux esophagitis after H. pylori eradication therapy was higher than that of control group(7.25% vs 4.20%; OR=1.62, 95%CI 1.20-2.19, P=0.002). Subgroup analysis found that Asian patients, 40 to 50 years old, follow-up time more than 1 year, and peptic ulcer had higher incidence of endoscopic reflux esophagitis; (2) The incidence of reflux symptoms was not significantly different between H. pylori eradication group and control group (25.2% vs 24.6%; OR=1.03, 95%CI 0.87-1.21, P=0.76). Further analysis indicated that reflux symptoms were not related to some relevant factors, such as races, age at diagnosis, follow-up time and underlying diseases.
  
  
  CONCLUSIONS
  The eradication of H. pylori is considered as one of risk factors for GERD, especially in Asian populations, long time follow-up, 40 to 50 years old and patients with peptic ulcer. Meanwhile, the eradication of H. pylori does not suggest the correlation with reflux symptoms. H. pylori eradication therapy should be administrated according to patients' individual conditions.
authors: Department of Gastroenterology, the First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, China.
authors: X T
authors: XT
authors: Wang
authors: M
authors: M
authors: Zhang
authors: C Y
authors: CY
authors: Chen
authors: B
authors: B
authors: Lyu
mesh_terms: D000328:Adult; D004941:Esophagitis / Q000209:etiology*; D004942:Esophagitis, Peptic / Q000209:etiology*; D005764:Gastroesophageal Reflux / Q000209:etiology* / Q000382:microbiology / Q000503:physiopathology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D012307:Risk Factors