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 30 August 2016

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Is H pylori associated with Barrett's esophagus, erosive esophagitis, and GERD?

February's issue of the Clinical Gastroenterology and Hepatology examines the association between Helicobacter pylori and Barrett's esophagus, erosive esophagitis, and gastroesophageal reflux symptoms.

News image

Infection with Helicobacter pylori, particularly the cytotoxin-associated gene A (cagA)+ strain, is believed to protect against Barrett's esophagus, but it is not clear if it protects against gastroesophageal reflux disease (GERD).

Dr Rubenstein and colleagues from Michigan, USA determined whether H pylori infection is associated with GERD symptoms, erosive esophagitis, and Barrett's esophagus within the same cohort.

The researchers analyzed data from a case–control study of 533 men who underwent colorectal cancer screening at 2 tertiary medical centers in Michigan between 2008 and 2011, and who also were recruited to undergo upper endoscopy.

The team assessed 80 additional men found to have Barrett's esophagus during clinically indicated upper-endoscopy examinations.

GERD symptoms were not associated with H pylori infection
Clinical Gastroenterology & Hepatology

Logistic regression was used to estimate the associations between serum antibodies against H pylori or cagA and GERD symptoms, esophagitis, and Barrett's esophagus, compared with randomly selected men undergoing colorectal cancer screens.

The research team found that H pylori infection was associated inversely with Barrett's esophagus, particularly the cagA+ strain.

The team observed a trend toward an inverse association with erosive esophagitis.

However, GERD symptoms were not associated with H pylori infection.

Dr Rubenstein's team concludes, "Based on a case–control study, infection with H pylori, particularly the cagA+ strain, is associated inversely with Barrett's esophagus."

"We observed a trend toward an inverse association with esophagitis, but not with GERD symptoms."

Clin Gastroenterol Hepatol 2014: 12(2): 239-245
29 January 2014

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