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In this study, Dr Hsiao-Bai Yang and team investigated whether Helicobacter pylori eradication limited the progression of intestinal metaplasia in patients with reflux esophagitis using long-term esomeprazole.
The team enrolled 325 reflux esophagitis patients in their study and assigned them to 1 of 3 groups:
- H. pylori-positive eradication group receiving 1-week triple therapy;
- H. pylori-positive non-eradication controls;
- H. pylori-negative controls.
All the patients received continuous esomeprazole until a sustained symptomatic response was achieved, then where possible, were shifted to on-demand therapy.
The team scheduled serial gastroscopy on enrollment, and at the end of the first and second years, to assess the prevalence and progression of gastric atrophy and intestinal metaplasia.
The research team found that there was significant regression of atrophy and intestinal metaplasia during follow-up in the H. pylori-positive eradication group.
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| There was significant regression of atrophy and intestinal metaplasia in the eradication group. |
| American Journal of Gastroenterology |
In contrast, prevalence rates of atrophy and intestinal metaplasia were significantly greater in the H. pylori-positive non-treated controls during follow-up.
Furthermore, during the second-year follow-up, the patients in the eradication group achieved more regression and less development of atrophy and intestinal metaplasia than the non-eradication controls. The team found that the negative controls had no progression of atrophy and intestinal metaplasia during follow-up.
Dr Yang and colleagues concluded, "In patients using long-term esomeprazole for reflux esophagitis, screening for and eradicating H. pylori infection are necessary in order to limit the progression or cause the regression of gastric precancerous changes."
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