OBJECTIVE: The role of Helicobacter pylori infection in the pathogenesis of gastroesophageal reflux disease (GORD) is controversial. We aimed to confirm the negative association between H. pylori infection and endoscopic GORD and further determine whether eradication of the infection is associated with the development of endoscopic GORD. MATERIALS AND METHODS: Case-control studies comparing the prevalence of H. pylori infection between patients with and those without GORD, type A cohort studies comparing the incidence of GORD between patients with and those without anti-H. pylori eradication therapy, and type B cohort studies comparing the incidence of GORD between H. pylori-positive patients with and those without successful eradication were included. Moreover, the effects of H. pylori eradication on the development of GORD in randomized-controlled trials were also analyzed. RESULTS: Overall, 43 studies were analyzed. Case-control studies showed a lower prevalence of H. pylori infection in patients with GORD [odds ratio 0.64, 95% confidence interval (CI) 0.49-0.83]. Type A cohort studies showed an increased incidence of GORD in patients whose H. pylori infection was successfully eradicated [risk ratio (RR) 2.50, 95% CI 1.46-4.26]. Type B cohort studies showed that patients whose H. pylori had been eradicated had a higher risk of GORD (RR 1.70, 95% CI 1.30-2.23). Moreover, randomized-controlled trials showed that H. pylori eradication leads to a higher risk of GORD (RR 1.99, 95% CI 1.23-3.22); subanalyses showed that the risk existed especially in Asian studies (RR 4.53, 95% CI 1.66-12.36). CONCLUSION: H. pylori infection shows a negative association with the development of endoscopic GORD. Eradication of the infection may be a risk factor for de-novo endoscopic GORD, especially in Asian populations.
OBJECTIVE: The role of Helicobacter pyloriinfection in the pathogenesis of gastroesophageal reflux disease (GORD) is controversial. We aimed to confirm the negative association between H. pyloriinfection and endoscopic GORD and further determine whether eradication of the infection is associated with the development of endoscopic GORD. MATERIALS AND METHODS: Case-control studies comparing the prevalence of H. pyloriinfection between patients with and those without GORD, type A cohort studies comparing the incidence of GORD between patients with and those without anti-H. pylori eradication therapy, and type B cohort studies comparing the incidence of GORD between H. pylori-positive patients with and those without successful eradication were included. Moreover, the effects of H. pylori eradication on the development of GORD in randomized-controlled trials were also analyzed. RESULTS: Overall, 43 studies were analyzed. Case-control studies showed a lower prevalence of H. pyloriinfection in patients with GORD [odds ratio 0.64, 95% confidence interval (CI) 0.49-0.83]. Type A cohort studies showed an increased incidence of GORD in patients whose H. pyloriinfection was successfully eradicated [risk ratio (RR) 2.50, 95% CI 1.46-4.26]. Type B cohort studies showed that patients whose H. pylori had been eradicated had a higher risk of GORD (RR 1.70, 95% CI 1.30-2.23). Moreover, randomized-controlled trials showed that H. pylori eradication leads to a higher risk of GORD (RR 1.99, 95% CI 1.23-3.22); subanalyses showed that the risk existed especially in Asian studies (RR 4.53, 95% CI 1.66-12.36). CONCLUSION:H. pyloriinfection shows a negative association with the development of endoscopic GORD. Eradication of the infection may be a risk factor for de-novo endoscopic GORD, especially in Asian populations.
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