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 27 May 2018

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H. pylori and hiatal hernia do not affect esophagitis severity in GERD

Helicobacter pylori infection and hiatal hernia do not affect the severity of esophagitis in patients with gastroesophageal reflux, according to a paper reported in the April issue of the Journal of Gastroenterology.

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A team from Mexico City, Mexico, assessed whether the presence of H. pylori and hiatal hernia affects the severity of esophagitis in patients with gastroesophageal reflux.

Included in the study were 37 patients with esophageal reflux and 14 healthy volunteers.

Reflux symptoms, endoscopy, H. pylori, esophageal manometry, and 24-hour pH monitoring were evaluated in each individual.

A total of 76% of the patients with esophageal reflux were positive for H. pylori; 81% had hiatal hernia, and only 43% showed an acid score by 24-hour pHmetry.

Esophageal reflux patients with H. pylori, hiatal hernia, and an acid score, demonstrated higher acid parameters compared with those in healthy volunteers.

Patients with an acid score who were negative for H. pylori tended toward more acid reflux events than patients with an acid score who were positive for the bacteria. This difference did not reach significance.

The same situation existed with patients with an acid score and hiatal hernia who were negative for H. pylori, but the tendency did not achieve significance.

No differences in:
- Esophageal wave amplitude/contraction
- No. of high-pressure/prolonged contractions
Journal of Gastroenterology
Results of an independent analysis of patients with Savary-Miller stage II and III esophagitis did not differ from the combined analysis of stage II and III patients.

Amplitude and contraction-duration parameters of the esophageal wave, and the number of high-pressure and prolonged contractions, were not found to be different among the reflux groups.

Wave amplitude in the lower third of the esophagus was significantly lower in esophagitis stage III patients with hiatal hernia compared with findings in the healthy volunteers. This was also the case in esophagitis stage II and III patients, combined, with H. pylori.

Richard A. Awad, of the Mexico City General Hospital, concluded on behalf of fellow authors, "These results suggest that H. pylori and hiatal hernia in patients with esophageal reflux do not constitute risk factors that affect the severity of esophagitis."

J Gastroenterol 2002; 37(4): 247-54
02 May 2002

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