OBJECTIVE: Gastroesophageal reflux disease (GERD) is a multifactorial disorder characterized by reflux of acidic gastric contents into the esophagus leading to tissue damage and symptoms. The role of H. pylori in the pathogenesis of GERD is controversial. Therefore, we performed a meta-analysis on the effect of H. pylori treatment on symptomatic as well as endoscopic changes associated with GERD. MATERIAL AND METHODS: Multiple medical databases were searched (4/2011). Randomized controlled trials (RCTs) comparing H. pylori treatment with no treatment on symptomatic adults with GERD were included. The effects of H. pylori eradication were analyzed by calculating pooled estimates for new onset or changes in the symptoms of GERD or endoscopic reflux esophagitis. Separate analyses were performed for each outcome by using odds ratio (OR) or weighted mean difference (WMD) by fixed and random effects models. Publication bias was assessed by funnel plots. Heterogeneity among studies was assessed by calculating I² measure of inconsistency. RESULTS: Ten trials met the inclusion criteria. No statistically significant effect was found for symptomatic GERD (OR 0.81, 95% CI 0.56-1.17, p = 0.27) or endoscopic evidence of reflux esophagitis (OR 1.13; 95% CI: 0.72-1.78, p = 0.59) between the two groups. A subgroup analysis of eradication data revealed a statistically significant lower incidence of GERD symptoms in the eradicated group (13.8%) compared with the non-eradicated group (24.9%) (OR 0.55; 95% CI: 0.35-0.87, p = 0.01). Funnel plot revealed no publication bias. CONCLUSIONS: Treatment of H. pylori does not seem to increase GERD symptoms or reflux esophagitis. However, documented eradication of H. pylori appears to significantly improve GERD symptoms.
OBJECTIVE:Gastroesophageal reflux disease (GERD) is a multifactorial disorder characterized by reflux of acidic gastric contents into the esophagus leading to tissue damage and symptoms. The role of H. pylori in the pathogenesis of GERD is controversial. Therefore, we performed a meta-analysis on the effect of H. pylori treatment on symptomatic as well as endoscopic changes associated with GERD. MATERIAL AND METHODS: Multiple medical databases were searched (4/2011). Randomized controlled trials (RCTs) comparing H. pylori treatment with no treatment on symptomatic adults with GERD were included. The effects of H. pylori eradication were analyzed by calculating pooled estimates for new onset or changes in the symptoms of GERD or endoscopic reflux esophagitis. Separate analyses were performed for each outcome by using odds ratio (OR) or weighted mean difference (WMD) by fixed and random effects models. Publication bias was assessed by funnel plots. Heterogeneity among studies was assessed by calculating I² measure of inconsistency. RESULTS: Ten trials met the inclusion criteria. No statistically significant effect was found for symptomatic GERD (OR 0.81, 95% CI 0.56-1.17, p = 0.27) or endoscopic evidence of reflux esophagitis (OR 1.13; 95% CI: 0.72-1.78, p = 0.59) between the two groups. A subgroup analysis of eradication data revealed a statistically significant lower incidence of GERD symptoms in the eradicated group (13.8%) compared with the non-eradicated group (24.9%) (OR 0.55; 95% CI: 0.35-0.87, p = 0.01). Funnel plot revealed no publication bias. CONCLUSIONS: Treatment of H. pylori does not seem to increase GERD symptoms or reflux esophagitis. However, documented eradication of H. pylori appears to significantly improve GERD symptoms.
Authors: Lori A Fischbach; David Y Graham; Jennifer R Kramer; Massimo Rugge; Gordana Verstovsek; Paola Parente; Abeer Alsarraj; Stephanie Fitzgerald; Yasser Shaib; Neena S Abraham; Anna Kolpachi; Swapna Gupta; Marcelo F Vela; Maria Velez; Rhonda Cole; Bhupinderjit Anand; Hashem B El Serag Journal: Am J Gastroenterol Date: 2014-01-14 Impact factor: 10.864
Authors: Felipe Mazzoleni; Luiz Edmundo Mazzoleni; Carlos Fernando de Magalhães Francesconi; Guilherme Becker Sander; Pâmela Schitz Von Reisswitz; Tobias Cancian Milbradt; Rafael da Veiga Chaves Picon; Diego Mendonça Uchoa; Laura Renata De Bona; Huander Felipe Andreolla; Helenice Pankowski Breyer; Ronaldo Spinato Torresini; Eduardo André Ott; André Castagna Wortmann; Alexandro de Lucena Theil; Jonathas Stifft; Raquel Petrucci Zenker; Candice Franke Krumel; Matheus Truccolo Michalczuk; Alexandre De Araujo; Ane Paula Canevese; Nadja Volpato; Cristiano André da Silva; Pedro Guilherme Schaefer; Natacha Fleck Titton; Larisse Longo; Maria Isabel Edelweiss; Daniel Simon; Nicholas Joseph Talley Journal: Int J Obes (Lond) Date: 2019-06-13 Impact factor: 5.095