Article
Inverse background of Helicobacter
pylori antibody and pepsinogen in reflux oesophagitis compared
with gastric cancer: analysis of 5732 Japanese
subjects
Y Yamajia c, T Mitsushimab c, H Ikumab, M Okamotoa c, H Yoshidaa, T Kawabea, Y Shiratoria, K Saitob, K Yokouchic, M Omataa
a Division of
Gastroenterology, Department of Internal Medicine, University of Tokyo,
Tokyo, Japan, b Department of Gastroenterology, Kameda General
Hospital, Kamogawa, Japan, c Makuhari Clinic, Chiba, Japan
Correspondence to: Dr Y Yamaji, Second Department of Internal Medicine, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. yamaji-tky{at}umin.ac.jp
Accepted for publication 23 January 2001
BACKGROUND
The
relationship between Helicobacter pylori and
reflux oesophagitis remains controversial.
AIMSTo evaluate the
relationship between H pylori and reflux
oesophagitis in a large number of Japanese subjects.
SUBJECTSA total of
5732 consecutive Japanese subjects during a health screening were enrolled.
METHODSGastrointestinal
endoscopy was performed on all subjects. We simultaneously measured
serum anti-H pylori antibody and pepsinogen as markers of H pylori infection together
with gastric atrophy. The risk of reflux oesophagitis was evaluated in
relation to these markers, and the results were compared with those of
gastric cancer.
RESULTSReflux
oesophagitis was found in 108 subjects. Both positivity for
H pylori antibody (adjusted odds ratio (OR)
0.67 (95% confidence interval 0.45-1.0))
and "low" pepsinogen indicating gastric atrophy (OR 0.35 (0.18-0.68)) were negatively associated with reflux oesophagitis. After subjects were classified into four groups based on positivity or
negativity for H pylori antibody and
"low" pepsinogen, the prevalence of reflux oesophagitis showed a
decreasing trend as H pylori induced gastric
atrophy became more severe. The risk of gastric cancer showed an
increasing trend, exactly the opposite to that of reflux oesophagitis.
CONCLUSIONSAnalysis
of a large series of Japanese subjects revealed a decreasing prevalence
of reflux oesophagitis in conjunction with progress of gastric atrophy
induced by H pylori infection. This pattern
was completely opposite to that of gastric cancer cases. A protective
role of H pylori for reflux oesophagitis
through the development of gastric atrophy has been suggested.
Keywords: Helicobacter pylori; oesophagitis; gastro-oesophageal reflux disease; atrophic gastritis; gastric cancer
© 2001 by Gut
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Relevant Article
- H pylori: the bug is not all bad
- J E RICHTER
Gut 2001 49: 319-320.[Extract] [Full Text] [PDF]
This article has been cited by other articles:
-
Watabe, H, Mitsushima, T, Yamaji, Y, Okamoto, M, Wada, R, Kokubo, T, Doi, H, Yoshida, H, Kawabe, T, Omata, M
(2005). Predicting the development of gastric cancer from combining Helicobacter pylori antibodies and serum pepsinogen status: a prospective endoscopic cohort study. Gut
54: 764-768
[Abstract] [Full Text] -
Malfertheiner, P, Peitz, U
(2005). The interplay between Helicobacter pylori, gastro-oesophageal reflux disease, and intestinal metaplasia. Gut
54: i13-i20
[Abstract] [Full Text] -
Harvey, R. F, Lane, J A., Murray, L. J, Harvey, I. M, Donovan, J. L, Nair, P.
(2004). Randomised controlled trial of effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux: Bristol helicobacter project. BMJ
328: 1417-
[Abstract] [Full Text] -
Malfertheiner, P
(2004). Helicobacter pylori eradication does not exacerbate gastro-oesophageal reflux disease. Gut
53: 312-313
[Abstract] [Full Text] -
RICHTER, J E
(2001). H pylori: the bug is not all bad. Gut
49: 319-320
[Full Text]
- Full Text
- Full Text (PDF)
- Alert me when this article is cited
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
