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Part of the confusion about the relationship between reflux symptoms and Helicobacter pylori infection arises because H pylori can be associated with both hyper- and hypo-acid secretion depending on whether antral gastritis or corpus gastritis predominate. The current study assessed symptoms of reflux, corpus atrophy, H pylori status, and the presence of the high producing interleukin 1ß (IL-1ß) polymorphism IL-1ß–511 C/T. The key finding was that homozygotes for the IL-1ß–511T polymorphism had a fivefold increased risk of atrophy (see table). They also found that homozygotes had a much reduced relative risk of reflux disease which was 0.14 (0.01–1.43) in H pylori negative and 0.14 (0.03-0.64) in H pylori positive patients. Thus genetically determined increased secretion of IL-1 ß is likely to mediate both corpus atrophy and inhibition of acid secretion which may account for the reduced risk of reflux symptoms observed in these patients.
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