BACKGROUND AND AIM: The relationship between gastroesophageal reflux disease (GERD) and Helicobacter pylori is controversial. We evaluated endoscopic, 24-h gastric and esophageal acid profile among patients with GERD in relation to H. pylori, as the latter might alter gastric acid secretion. METHODS: Patients with GERD (n = 123), who were not on acid-suppressive drugs, and had not received anti-H. pylori therapy, underwent gastroduodenoscopy and tests for H. pylori detection. Esophageal manometry, 24-h pH metry, serum pepsinogen-I (PG-I), PG-II and gastrin-17 ELISA were done in all these patients. Univariate and multivariate analyses were performed to assess independent predictors for erosive esophagitis (EE). RESULTS: Of 123 patients (mean age 40.5 [13.1] years, 85 [69.1%] men), 59 (47.9%) had H. pylori infection. EE was more common in H. pylori non-infected than infected (49 vs. 32, p < 0.001). Among patients older than 40 years, absence of H. pylori was associated with lower esophageal pH and longer reflux (p = 0.02 and p < 0.001, respectively). PG-I/PG-II ratio was lower in H. pylori infected subjects (p < 0.001). In patients with higher LA grade of esophagitis, elevated PG-I levels and PG-I/PG-II ratio were associated with more acidic stomach (p = 0.04 and p = 0.01, respectively). Multivariate analyses showed low gastrin-17 (p = 0.016), higher age (p = 0.013), hiatus hernia (p = 0.004) and absence of H. pylori (p = 0.03) were independent predictors for risk of EE. CONCLUSION: H. pylori infection is associated with less acidic stomach and less severe GERD. Low gastrin-17, higher age, hiatus hernia and absence of H. pylori were the best predictors for EE risk.
BACKGROUND AND AIM: The relationship between gastroesophageal reflux disease (GERD) and Helicobacter pylori is controversial. We evaluated endoscopic, 24-h gastric and esophageal acid profile among patients with GERD in relation to H. pylori, as the latter might alter gastric acid secretion. METHODS:Patients with GERD (n = 123), who were not on acid-suppressive drugs, and had not received anti-H. pylori therapy, underwent gastroduodenoscopy and tests for H. pylori detection. Esophageal manometry, 24-h pH metry, serum pepsinogen-I (PG-I), PG-II and gastrin-17 ELISA were done in all these patients. Univariate and multivariate analyses were performed to assess independent predictors for erosive esophagitis (EE). RESULTS: Of 123 patients (mean age 40.5 [13.1] years, 85 [69.1%] men), 59 (47.9%) had H. pylori infection. EE was more common in H. pylorinon-infected than infected (49 vs. 32, p < 0.001). Among patients older than 40 years, absence of H. pylori was associated with lower esophageal pH and longer reflux (p = 0.02 and p < 0.001, respectively). PG-I/PG-II ratio was lower in H. pylori infected subjects (p < 0.001). In patients with higher LA grade of esophagitis, elevated PG-I levels and PG-I/PG-II ratio were associated with more acidic stomach (p = 0.04 and p = 0.01, respectively). Multivariate analyses showed low gastrin-17 (p = 0.016), higher age (p = 0.013), hiatus hernia (p = 0.004) and absence of H. pylori (p = 0.03) were independent predictors for risk of EE. CONCLUSION: H. pylori infection is associated with less acidic stomach and less severe GERD. Low gastrin-17, higher age, hiatus hernia and absence of H. pylori were the best predictors for EE risk.
Authors: Pentti Sipponen; Matti Vauhkonen; Timo Helske; Ilpo Kaariainen; Matti Harkonen Journal: World J Gastroenterol Date: 2005-10-14 Impact factor: 5.742
Authors: J C Wu; J J Sung; E K Ng; M Y Go; W B Chan; F K Chan; W K Leung; C L Choi; S C Chung Journal: Am J Gastroenterol Date: 1999-07 Impact factor: 10.864
Authors: B E Schenk; E J Kuipers; E C Klinkenberg-Knol; H P Festen; E H Jansen; H A Tuynman; M Schrijver; L A Dieleman; S G Meuwissen Journal: Am J Gastroenterol Date: 1997-11 Impact factor: 10.864
Authors: F Cremonini; S Di Caro; S Delgado-Aros; A Sepulveda; G Gasbarrini; A Gasbarrini; M Camilleri Journal: Aliment Pharmacol Ther Date: 2003-08-01 Impact factor: 8.171
Authors: Shobna J Bhatia; D Nageshwar Reddy; Uday C Ghoshal; V Jayanthi; Philip Abraham; Gourdas Choudhuri; S L Broor; Vineet Ahuja; Philip Augustine; V Balakrishnan; D K Bhasin; Naresh Bhat; Ashok Chacko; Sunil Dadhich; G K Dhali; Pankaj S Dhawan; Manisha Dwivedi; Mahesh K Goenka; Abraham Koshy; Ajay Kumar; Sri Prakash Misra; Shrikant Mukewar; E PedaVeer Raju; K T Shenoy; S P Singh; Ajit Sood; R Srinivasan Journal: Indian J Gastroenterol Date: 2011-07-27