OBJECTIVES: To investigate the effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux. DESIGN: Cross sectional study, followed by a randomised placebo controlled trial. SETTING: Seven general practices in Bristol, England. PARTICIPANTS: 10,537 people, aged 20-59 years, with and without H pylori infection (determined by the (13)C-urea breath test). MAIN OUTCOME MEASURES: Prevalence of heartburn and gastro-oesophageal acid reflux at baseline and two years after treatment to eradicate H pylori infection. RESULTS: At baseline, H pylori infection was associated with increased prevalence of heartburn (odds ratio 1.14, 95% confidence interval 1.05 to 1.23) but not reflux (1.05, 0.97 to 1.14). In participants with H pylori infection, active treatment had no effect on the overall prevalence of heartburn (0.99, 0.88 to 1.12) or reflux (1.04, 0.91 to 1.19) and did not improve pre-existing symptoms of heartburn or reflux. CONCLUSIONS: H pylori infection is associated with a slightly increased prevalence of heartburn but not reflux. Treatment to eradicate H pylori has no net benefit in patients with heartburn or gastro-oesophageal reflux.
RCT Entities:
OBJECTIVES: To investigate the effects of Helicobacter pyloriinfection and its eradication on heartburn and gastro-oesophageal reflux. DESIGN: Cross sectional study, followed by a randomised placebo controlled trial. SETTING: Seven general practices in Bristol, England. PARTICIPANTS: 10,537 people, aged 20-59 years, with and without H pylori infection (determined by the (13)C-urea breath test). MAIN OUTCOME MEASURES: Prevalence of heartburn and gastro-oesophageal acid reflux at baseline and two years after treatment to eradicate H pylori infection. RESULTS: At baseline, H pylori infection was associated with increased prevalence of heartburn (odds ratio 1.14, 95% confidence interval 1.05 to 1.23) but not reflux (1.05, 0.97 to 1.14). In participants with H pylori infection, active treatment had no effect on the overall prevalence of heartburn (0.99, 0.88 to 1.12) or reflux (1.04, 0.91 to 1.19) and did not improve pre-existing symptoms of heartburn or reflux. CONCLUSIONS:H pylori infection is associated with a slightly increased prevalence of heartburn but not reflux. Treatment to eradicate H pylori has no net benefit in patients with heartburn or gastro-oesophageal reflux.
Authors: E M El-Omar; K Oien; A El-Nujumi; D Gillen; A Wirz; S Dahill; C Williams; J E Ardill; K E McColl Journal: Gastroenterology Date: 1997-07 Impact factor: 22.682
Authors: P Moayyedi; R Feltbower; J Brown; S Mason; J Mason; J Nathan; I D Richards; A C Dowell; A T Axon Journal: Lancet Date: 2000-05-13 Impact factor: 79.321
Authors: H Hamada; K Haruma; M Mihara; T Kamada; M Yoshihara; K Sumii; G Kajiyama; M Kawanishi Journal: Aliment Pharmacol Ther Date: 2000-06 Impact factor: 8.171
Authors: J Athene Lane; Liam J Murray; Sian Noble; Matthias Egger; Ian M Harvey; Jenny L Donovan; Prakash Nair; Richard F Harvey Journal: BMJ Date: 2006-01-20