It has been suggested that Helicobacter pylori infection may prevent gastroesophageal reflux, possibly through gastric atrophy.
Previous results are contradictory and no population-based studies are available.
The relationship between H pylori and reflux remains uncertain.
Dr Helena Nordenstedt and colleagues from Norway investigated this relationship in a population-based, nested, case-control study.
The researchers assessed a cohort of 65,363 individuals, representing 71% of the adult population.
The team randomly selected 472 persons with recurrent reflux symptoms, and 472 without such symptoms as controls.
|H pylori infection increased gastric atrophy 9-fold|
Occurrence of H pylori and its virulence factor cagA was determined serologically, using an immunoblot assay.
The research team assessed gastric atrophy through serum levels of pepsinogen I.
Odds ratios with 95% confidence intervals, adjusted for potential confounding factors, represented relative risks.
H pylori infection was not associated with a decreased risk of reflux symptoms, irrespective of positive cagA status.
The researchers found that gastric atrophy reduced the risk of reflux symptoms.
The team noted that infection with H pylori entailed a 9-fold increase in the risk of gastric atrophy compared to non-infection.
Dr Nordenstedt's team concludes, “H pylori infection, irrespective of cagA status, did not affect the occurrence of reflux symptoms in this population-based setting.”
“Infected individuals are at increased risk of gastric atrophy, which in turn reduces reflux symptoms.”
“However, due to the low frequency of gastric atrophy among infected individuals overall, there was no association with reflux symptoms on a population level.”