Helicobacter pylori infection is not involved in the pathogenesis of either erosive or non-erosive gastro-oesophageal reflux disease

P. Zentilin, E. Iiritano, C. Vignale, C. Bilardi, M. R. Mele, P. Spaggiari, C. Gambaro, P. Dulbecco, L. Tessieri, S. Reglioni, C. Mansi, L. Mastracci, S. Vigneri, R. Fiocca, V. Savarino

Research output: Contribution to journalArticle

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Abstract

Background: The majority of reflux patients have non-erosive reflux disease. Aim: To evaluate the influence of Helicobacter pylori on oesophageal acid exposure in patients with both non-erosive and erosive reflux disease and in a group of controls. The pattern and distribution of chronic gastritis were also assessed. Methods: One hundred and twelve consecutive patients with symptoms of gastro-oesophageal reflux disease agreed to undergo both upper gastrointestinal endoscopy and 24-h oesophageal pH-metry. Patients were grouped as H. pylori-positive or H. pylori-negative on the basis of both CLO-test and histology, and as cases with or without oesophagitis on the basis of endoscopy. The controls consisted of 19 subjects without reflux symptoms and with normal endoscopy and oesophageal pH-metry. Results: H. pylori was positive in 35 patients (31%) and in six controls (31%): oesophagitis was found in 44 patients (39%) and non-erosive reflux disease in 68 (61%). The prevalence of chronic gastritis in the antrum and corpus was higher in H. pylori-positive than in H. pylori-negative patients (P <0.001), but was more frequently mild (P <0.001) than moderate or severe. The percentage total time the oesophageal pH <4.0 was higher in patients than in controls (P <0.008-0.001), but there was no difference between H. pylori-positive and H. pylori-negative patients (12.3% vs. 12%, P = 0.43) or H. pylori-positive and H. pylori-negative controls (1.07% vs. 1.47%. P = 0.19). Conclusions: H. pylori infection had the same prevalence in reflux patients and in controls. It did not affect oesophageal acid exposure, as there was no difference between H. pylori-positive and H. pylori-negative individuals. The high prevalence of mild body gastritis in H. pylori-positive patients suggests that H. pylori eradication is unlikely to lead to gastric functional recovery, which might precipitate or worsen symptoms and lesions in patients with gastro-oesophageal reflux disease.

Original languageEnglish
Pages (from-to)1057-1064
Number of pages8
JournalAlimentary Pharmacology and Therapeutics
Volume17
Issue number8
DOIs
Publication statusPublished - Apr 15 2003

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Esophageal Diseases
Helicobacter Infections
Gastroesophageal Reflux
Helicobacter pylori
Gastritis
Esophagitis
Endoscopy
Acids
Gastrointestinal Endoscopy

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

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Helicobacter pylori infection is not involved in the pathogenesis of either erosive or non-erosive gastro-oesophageal reflux disease. / Zentilin, P.; Iiritano, E.; Vignale, C.; Bilardi, C.; Mele, M. R.; Spaggiari, P.; Gambaro, C.; Dulbecco, P.; Tessieri, L.; Reglioni, S.; Mansi, C.; Mastracci, L.; Vigneri, S.; Fiocca, R.; Savarino, V.

In: Alimentary Pharmacology and Therapeutics, Vol. 17, No. 8, 15.04.2003, p. 1057-1064.

Research output: Contribution to journalArticle

Zentilin, P, Iiritano, E, Vignale, C, Bilardi, C, Mele, MR, Spaggiari, P, Gambaro, C, Dulbecco, P, Tessieri, L, Reglioni, S, Mansi, C, Mastracci, L, Vigneri, S, Fiocca, R & Savarino, V 2003, 'Helicobacter pylori infection is not involved in the pathogenesis of either erosive or non-erosive gastro-oesophageal reflux disease', Alimentary Pharmacology and Therapeutics, vol. 17, no. 8, pp. 1057-1064. https://doi.org/10.1046/j.1365-2036.2003.01547.x
Zentilin, P. ; Iiritano, E. ; Vignale, C. ; Bilardi, C. ; Mele, M. R. ; Spaggiari, P. ; Gambaro, C. ; Dulbecco, P. ; Tessieri, L. ; Reglioni, S. ; Mansi, C. ; Mastracci, L. ; Vigneri, S. ; Fiocca, R. ; Savarino, V. / Helicobacter pylori infection is not involved in the pathogenesis of either erosive or non-erosive gastro-oesophageal reflux disease. In: Alimentary Pharmacology and Therapeutics. 2003 ; Vol. 17, No. 8. pp. 1057-1064.
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abstract = "Background: The majority of reflux patients have non-erosive reflux disease. Aim: To evaluate the influence of Helicobacter pylori on oesophageal acid exposure in patients with both non-erosive and erosive reflux disease and in a group of controls. The pattern and distribution of chronic gastritis were also assessed. Methods: One hundred and twelve consecutive patients with symptoms of gastro-oesophageal reflux disease agreed to undergo both upper gastrointestinal endoscopy and 24-h oesophageal pH-metry. Patients were grouped as H. pylori-positive or H. pylori-negative on the basis of both CLO-test and histology, and as cases with or without oesophagitis on the basis of endoscopy. The controls consisted of 19 subjects without reflux symptoms and with normal endoscopy and oesophageal pH-metry. Results: H. pylori was positive in 35 patients (31{\%}) and in six controls (31{\%}): oesophagitis was found in 44 patients (39{\%}) and non-erosive reflux disease in 68 (61{\%}). The prevalence of chronic gastritis in the antrum and corpus was higher in H. pylori-positive than in H. pylori-negative patients (P <0.001), but was more frequently mild (P <0.001) than moderate or severe. The percentage total time the oesophageal pH <4.0 was higher in patients than in controls (P <0.008-0.001), but there was no difference between H. pylori-positive and H. pylori-negative patients (12.3{\%} vs. 12{\%}, P = 0.43) or H. pylori-positive and H. pylori-negative controls (1.07{\%} vs. 1.47{\%}. P = 0.19). Conclusions: H. pylori infection had the same prevalence in reflux patients and in controls. It did not affect oesophageal acid exposure, as there was no difference between H. pylori-positive and H. pylori-negative individuals. The high prevalence of mild body gastritis in H. pylori-positive patients suggests that H. pylori eradication is unlikely to lead to gastric functional recovery, which might precipitate or worsen symptoms and lesions in patients with gastro-oesophageal reflux disease.",
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T1 - Helicobacter pylori infection is not involved in the pathogenesis of either erosive or non-erosive gastro-oesophageal reflux disease

AU - Zentilin, P.

AU - Iiritano, E.

AU - Vignale, C.

AU - Bilardi, C.

AU - Mele, M. R.

AU - Spaggiari, P.

AU - Gambaro, C.

AU - Dulbecco, P.

AU - Tessieri, L.

AU - Reglioni, S.

AU - Mansi, C.

AU - Mastracci, L.

AU - Vigneri, S.

AU - Fiocca, R.

AU - Savarino, V.

PY - 2003/4/15

Y1 - 2003/4/15

N2 - Background: The majority of reflux patients have non-erosive reflux disease. Aim: To evaluate the influence of Helicobacter pylori on oesophageal acid exposure in patients with both non-erosive and erosive reflux disease and in a group of controls. The pattern and distribution of chronic gastritis were also assessed. Methods: One hundred and twelve consecutive patients with symptoms of gastro-oesophageal reflux disease agreed to undergo both upper gastrointestinal endoscopy and 24-h oesophageal pH-metry. Patients were grouped as H. pylori-positive or H. pylori-negative on the basis of both CLO-test and histology, and as cases with or without oesophagitis on the basis of endoscopy. The controls consisted of 19 subjects without reflux symptoms and with normal endoscopy and oesophageal pH-metry. Results: H. pylori was positive in 35 patients (31%) and in six controls (31%): oesophagitis was found in 44 patients (39%) and non-erosive reflux disease in 68 (61%). The prevalence of chronic gastritis in the antrum and corpus was higher in H. pylori-positive than in H. pylori-negative patients (P <0.001), but was more frequently mild (P <0.001) than moderate or severe. The percentage total time the oesophageal pH <4.0 was higher in patients than in controls (P <0.008-0.001), but there was no difference between H. pylori-positive and H. pylori-negative patients (12.3% vs. 12%, P = 0.43) or H. pylori-positive and H. pylori-negative controls (1.07% vs. 1.47%. P = 0.19). Conclusions: H. pylori infection had the same prevalence in reflux patients and in controls. It did not affect oesophageal acid exposure, as there was no difference between H. pylori-positive and H. pylori-negative individuals. The high prevalence of mild body gastritis in H. pylori-positive patients suggests that H. pylori eradication is unlikely to lead to gastric functional recovery, which might precipitate or worsen symptoms and lesions in patients with gastro-oesophageal reflux disease.

AB - Background: The majority of reflux patients have non-erosive reflux disease. Aim: To evaluate the influence of Helicobacter pylori on oesophageal acid exposure in patients with both non-erosive and erosive reflux disease and in a group of controls. The pattern and distribution of chronic gastritis were also assessed. Methods: One hundred and twelve consecutive patients with symptoms of gastro-oesophageal reflux disease agreed to undergo both upper gastrointestinal endoscopy and 24-h oesophageal pH-metry. Patients were grouped as H. pylori-positive or H. pylori-negative on the basis of both CLO-test and histology, and as cases with or without oesophagitis on the basis of endoscopy. The controls consisted of 19 subjects without reflux symptoms and with normal endoscopy and oesophageal pH-metry. Results: H. pylori was positive in 35 patients (31%) and in six controls (31%): oesophagitis was found in 44 patients (39%) and non-erosive reflux disease in 68 (61%). The prevalence of chronic gastritis in the antrum and corpus was higher in H. pylori-positive than in H. pylori-negative patients (P <0.001), but was more frequently mild (P <0.001) than moderate or severe. The percentage total time the oesophageal pH <4.0 was higher in patients than in controls (P <0.008-0.001), but there was no difference between H. pylori-positive and H. pylori-negative patients (12.3% vs. 12%, P = 0.43) or H. pylori-positive and H. pylori-negative controls (1.07% vs. 1.47%. P = 0.19). Conclusions: H. pylori infection had the same prevalence in reflux patients and in controls. It did not affect oesophageal acid exposure, as there was no difference between H. pylori-positive and H. pylori-negative individuals. The high prevalence of mild body gastritis in H. pylori-positive patients suggests that H. pylori eradication is unlikely to lead to gastric functional recovery, which might precipitate or worsen symptoms and lesions in patients with gastro-oesophageal reflux disease.

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