The effect of <scp>Helicobacter pylori</scp> and its eradication on gastro‐oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis

Raghunath, A. S.; Hungin, A. P. S.; Wooff, David; Childs, S.

doi:10.1111/j.1365-2036.2004.02172.x

Cited by 75 publications

(69 citation statements)

References 51 publications

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“…6,19,31 A recent systematic review did not find any significant differences between H. pylori positive and negative GERD patients in respect of healing rates, time to relapse, ph values and recurrence of symptoms. 32 However, our finding is consistent with a subsequent trial of H. pylori positive patients from this cohort, where eradication reduced overall dyspepsia scores (measured by the LDQ), but not reflux scores (measured by the CDRQ) and consequently, reflux was more likely to be the residual predominant symptom. 8 Helicobacter pylori negative patients may have worse oesophagitis than those who are H. pylori positive 33,34 and this may be especially important in relation to cagA status.…”

Section: Discussionsupporting

confidence: 91%

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

Raghunath

Hungin

Mason

et al. 2009

Aliment Pharmacol Ther

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Section: Discussionsupporting

confidence: 91%

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

Raghunath

Hungin

Mason

et al. 2009

Aliment Pharmacol Ther

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“…(24). Similar conclusions were drawn in a systematic review, which found no evidence that H. pylori eradication in patients with DU might provoke refl ux esophagitis (25). Pathophysiologically, most of the DU cases are associated with antrum-predominant H. pylori gastritis with increased gastric acid secretion; therefore, such patients might be at increased risk for developing GERD and DU, and both conditions might improve after H. pylori eradication (11).…”

Section: Discussionsupporting

confidence: 57%

De novo erosive esophagitis in duodenal ulcer patients related to pre-existing reflux symptoms, smoking, and patient age, but not to Helicobacter pylori eradication: a one-year follow-up study

Jonaitis¹,

Kupčinskas²,

Kiudelis³

et al. 2010

Medicina

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It remains unclear whether the Helicobacter pylori eradication may cause or provoke gastroesophageal reflux disease. Therefore, we aimed to elucidate the role of H. pylori eradication and other factors in the development of erosive esophagitis in patients with duodenal ulcer. Materials and methods. We enrolled 183 H. pylori-positive duodenal ulcer patients without erosive esophagitis. Final endoscopy was performed 12 months later or in case if ulcer relapse was suspected. H. pylori was diagnosed by the urease test and histology if the results of at least one of the tests were positive. A total of 142 patients were assigned to the eradication treatment. The control group included 41 volunteers – 20-mg omeprazole b.i.d. for 4 weeks was administered. Results. A total of 150 patients completed the study. Of the 119 patients, 70 (58.8%) were cured from H. pylori, and in 49 (41.2%) of patients, treatment of H. pylori was unsuccessful. All 31 controls remained H. pylori-positive. At the final endoscopy, erosive esophagitis was found in 19 (12.7%) patients. Erosive esophagitis developed in 8 (11.4%) successfully eradicated patients, in 9 (18.4%) unsuccessfully treated patients, and in 2 (6.5%) controls (P>0.05 comparing the groups). Multivariate logistic regression analysis revealed 3 factors at baseline, which were significant (P<0.05) in predicting the occurrence of erosive esophagitis: age more than 43 years (OR, 4.96; 95% CI, 1.47–16.71), nonerosive gastroesophageal reflux disease (OR, 3.96; 95% CI, 1.34–11.68), and smoking (OR, 3.17; 95% CI, 1.01–9.17). Conclusions. H. pylori eradication did not influence the incidence of erosive esophagitis in patients with duodenal ulcer during a one-year follow-up period. Pre-existing nonerosive gastroesophageal reflux disease, smoking, and older age are important predictors of de novo development of erosive esophagitis.

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“…A systematic review of 27 published studies concluded that eradication of H. pylori infection from patients with duodenal ulcer did not predispose to the development of GERD ( 49 ) or worsen symptoms in patients with established GERD ( 49 ).…”

Section: Gastroesophageal Refl Ux Disease (Gerd)mentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,268

1,505

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Helicobacter pylori ( H. pylori ) infection is a common worldwide infection that is an important cause of peptic ulcer disease and gastric cancer. H. pylori may also have a role in uninvestigated and functional dyspepsia, ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-infl ammatory medication, unexplained iron defi ciency anemia, and idiopathic thrombocytopenic purpura. While choosing a treatment regimen for H. pylori , patients should be asked about previous antibiotic exposure and this information should be incorporated into the decision-making process. For fi rst-line treatment, clarithromycin triple therapy should be confi ned to patients with no previous history of macrolide exposure who reside in areas where clarithromycin resistance amongst H. pylori isolates is known to be low. Most patients will be better served by fi rst-line treatment with bismuth quadruple therapy or concomitant therapy consisting of a PPI, clarithromycin, amoxicillin, and metronidazole. When fi rst-line therapy fails, a salvage regimen should avoid antibiotics that were previously used. If a patient received a fi rst-line treatment containing clarithromycin, bismuth quadruple therapy or levofl oxacin salvage regimens are the preferred treatment options. If a patient received fi rst-line bismuth quadruple therapy, clarithromycin or levofl oxacin-containing salvage regimens are the preferred treatment options. Details regarding the drugs, doses and durations of the recommended and suggested fi rst-line and salvage regimens can be found in the guideline. Asia and Central and South America ( 8,22 ). Th ere is, however, preliminary evidence that it may be falling in some previously high prevalence areas ( 22 ). People immigrating to North America from Asia and other parts of the world have a much higher prevalence of the infection than people born in North America ( 23 ). In one study, the seroprevalence among immigrants from East Asia was 70.1% ( 24 ). Hispanic immigrants to North America have higher rates of the infection than fi rst-or second-generation Hispanics who were born here ( 25 ). QUESTION 2: WHAT ARE THE INDICATIONS TO TEST FOR, AND TO TREAT, H. PYLORI INFECTION? RecommendationsSince all patients with a positive test of active infection with H. pylori should be off ered treatment, the critical issue is which patients should be tested for the infection (strong recommendation, quality of evidence: not applicable), All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Th ose who test positive should be off ered treatment for the infection (strong recommendation, quality of evidence: high for active or history of PUD, low for MALT lymphoma, low for history of endoscopic resection of EGC).In patients with uninvestigated d...

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The effect of Helicobacter pylori and its eradication on gastro‐oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis

Cited by 75 publications

References 51 publications

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

Symptoms in patients on long‐term proton pump inhibitors: prevalence and predictors

De novo erosive esophagitis in duodenal ulcer patients related to pre-existing reflux symptoms, smoking, and patient age, but not to Helicobacter pylori eradication: a one-year follow-up study

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

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