The relationship between Helicobacter pylori (H. pylori) infections and reflux esophagitis is unclear.
A group of Japanese scientists have therefore investigated the effects of H. pylori eradication on the reflux esophagitis present in patients with peptic ulcers.
The researchers recruited 162 H. pylori-positive patients among whom prospective post-eradication evaluations had been carried out yearly.
All subjects suffered from reflux esophagitis together with peptic ulcer disease.
The study cohort consisted of 4 women and 158 men, with a mean age of 49.1 years.
Using the Los Angeles classification, 90 patients were ranked grade A for their esophagitis, 63 grade B, and 9 grade C.
Follow-up evaluations were commenced 1 to 2 months after completion of eradication therapy, with a mean follow-up time of 22 months.
|H. pylori eradication – one of several independent factors for improvement of reflux esophagitis in patients with duodenal ulcer|
| Clinical Gastroenterology and Hepatology |
These consisted of endoscopy and an interview with the patients to determine their levels of heartburn.
Due to adverse drug reactions or a failure to regularly attend appointments, 6 patients were withdrawn from the study.
Endoscopic observations following eradication therapy identified improvements in reflux esophagitis in 87 (56%) of the 156 patients remaining in the study.
It was noted that these improvements were significantly higher in those patients where there had been complete H. pylori eradication (61%) compared to those patients with persistent H. pylori infection (40%).
Investigating further, the researchers found that body mass index, cure of infection, the absence of a hiatal hernia and an ulcer located in the duodenum were all significant independent factors for the improvement of reflux esophagitis.
Kuniharu Ishiki, from the Department of Internal Medicine, Nippon Kokan Fukuyama Hospital, Daimon-cho, Fukuyama, Japan, and one of the co-authors of the study, commenting on their work said that it showed that. "In patients with reflux esophagitis associated with duodenal ulcer, a significant improvement in pre-existing reflux esophagitis was noted after H. pylori eradication."