Esophagitis and Helicobacter pylori

• Helicobacter pylori eradication, if present, does not heal or prevent relapse gastro-oesophageal reflux disease (1)

The relationship between Helicobacter pylori infection and gastroesophageal reflux disease (GORD) has been debated for many years and is still unclear (2,3)

• both a protective and an aggressive role for Hp on GORD-incidence and severity have been suggested, while other authors proposed an independent coincidence of the two conditions
  • Zentiline et al showed '...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...' (2)

Reference:

• Dent J et al. An evidence-based appraisal of reflux disease management - the Genval workshop report. Gut (1999), 44 (Suppl 2).
• Zentiline P et al. Helicobacter pylori infection is not involved in the pathogenesis of either erosive or non-erosive gastro-oesophageal reflux disease. Aliment Pharmacol Ther. 2003;17:1057-64.
• Ghoshal UC, Chourasia D. Gastroesophageal reflux disease and Helicobacter pylori: what may be the relationship? J Neurogastroenterol Motil. 2010;16:243-50.