Clinical studyThe association between CagA status and the development of esophagitis after the eradication of helicobacter pylori
Section snippets
Sample
We studied consecutive H. pylori–positive patients who did not have symptoms of gastroesophageal reflux disease (ie, heartburn, regurgitation, dysphagia, or chest pain) and who had normal esophageal mucosa and no evidence of hiatus hernia at endoscopy immediately before H. pylori treatment. None of the patients had regularly used antisecretory drugs (eg, proton pump inhibitors) for the previous 3 months, to avoid the possibility of prior antisecretory therapy masking gastroesophageal reflux
Results
Fifty H. pylori-positive patients (30 men; median age 42 years, range 21 to 57)], including 25 with duodenal ulcer, completed the study (Table). No relapses of H. pylori infection or peptic ulcer were observed during follow-up. Twenty-two (44%) of the patients were CagA-positive. During follow-up, symptoms of gastroesophageal reflux disease (heartburn) developed in 12 (24%) patients; at endoscopy, esophagitis was found in all 12 of these patients (7 with stage I and 5 with stage II esophagitis).
Discussion
H. pylori eradication is the treatment of choice to cure peptic ulcer and H. pylori-related gastritis. Eradication may not be free of adverse consequences, however, especially the development of gastroesophageal reflux disease. The hypothesis that patients infected with H. pylori might have a lower risk of gastroesophageal reflux disease (15) is supported by the observation that cagA-positive strains of H. pylori may protect against complications of gastroesophageal reflux disease, such as
References (51)
Campylobacter pylori and peptic ulcer disease
Gastroenterology
(1989)- et al.
Helicobacter pylori eradication reduces the rate of rebleeding in ulcer haemorrhage
Gastrointest Endosc
(1995) - et al.
Eradication of Helicobacter pylori reduces the possibility of rebleeding in peptic ulcer disease
Gastrointest Endosc
(1995) - et al.
Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis
Gastroenterology
(1997) - et al.
The endoscopic assessment of esophagitisa progress report on observer agreement
Gastroenterology
(1996) - et al.
The effect of ammonia on omeprazole-induced reduction of gastric acidity in subjects with Helicobacter pylori infection
Am J Gastroenterol
(2000) - et al.
Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease
Gastroenterology
(1995) - et al.
Relationship between lower esophageal sphincter pressure and serum gastrin concentration in Zollingrer-Ellison syndrome and other clinical settings
Gastroenterology
(1979) - et al.
Does cure of Helicobacter pylori infection induce heartburn?
Gastroenterology
(1998) - et al.
Symptomatic benefit 1–3 years after H
pylori eradication in ulcer patients: impact of gastroesophageal reflux disease. Am J Gastroenterol.
(2000)