Article
Helicobacter pylori infection prevents
erosive reflux oesophagitis by decreasing gastric acid
secretion
T Koike, S Ohara, H Sekine, K Iijima, Y Abe, K Kato, T Toyota, T Shimosegawa
Department of
Gastroenterology, Tohoku University Graduate School of Medicine,
Sendai, Miyagi 980-8574, Japan
Correspondence to: Dr T Koike, Department of Gastroenterology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan. tkoike{at}rds.so-net.ne.jp
Accepted for publication 5 December 2000
BACKGROUND
Helicobacter
pylori infection is less prevalent and atrophic gastritis is
less extensive in patients with reflux oesophagitis than those without
it, but few studies have examined this relationship directly.
AIMSWe investigated
the relationship between H pylori infection,
acid secretion, and reflux oesophagitis in Japanese subjects.
SUBJECTSA total of
105 patients with erosive reflux oesophagitis were compared with 105 sex and age matched patients without reflux oesophagitis.
METHODSThe diagnosis
of H pylori infection was made by
histological examination of gastric mucosal biopsy specimens, rapid
urease test, and detection of serum IgG antibodies. Acid secretion was assessed by the endoscopic gastrin test.
RESULTSH
pylori infection was present in 36 patients with erosive reflux
oesophagitis (34.3%) and in 80 control subjects (76.2%) (odds ratio
0.163, 95% confidence interval 0.09-0.29). Overall acid secretion was
significantly greater in patients with reflux oesophagitis. Among
H pylori positive patients, acid secretion was greater in patients with reflux oesophagitis than those
without oesophagitis.
CONCLUSIONIn Japan,
erosive reflux oesophagitis occurs most often in the absence of
H pylori infection and gastric
hyposecretion. Even in the presence of H
pylori infection, reflux oesophagitis is more likely to develop
in patients without gastric hyposecretion. H
pylori infection may inhibit reflux oesophagitis by inducing hypoacidity.
Keywords: Helicobacter pylori; gastro-oesophageal reflux disease; reflux oesophagitis; acid secretion
© 2001 by Gut
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