Article Text

Download PDFPDF
The interplay between Helicobacter pylori, gastro-oesophageal reflux disease, and intestinal metaplasia
  1. P Malfertheiner,
  2. U Peitz
  1. Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University, Germany
  1. Correspondence to:
    P Malfertheiner
    Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany;


Helicobacter pylori infection and gastro-oesophageal reflux disease (GERD) account for most upper gastrointestinal pathologies with a wide spectrum of clinical manifestations. The interplay of both conditions is complex, in part intriguing, and has become a matter of debate because of conflicting results. The cardia is an area where both H pylori and abnormal GERD exert their damaging potential, inducing inflammation and its consequences, such as intestinal metaplasia. While the role of intestinal metaplasia within columnar lined epithelium (Barrett’s oesophagus) in the context of GERD is well established as a risk for neoplasia development, the role of intestinal metaplasia at the cardia in the context of H pylori infection is unclear. A particular challenge is the distinction of intestinal metaplasia as a consequence of GERD or H pylori if both conditions are concomitant. Available data on this issue, including follow up of a small patient series, are presented, but more studies are required to shed light on this issue because they will help to identify those patients that need surveillance.

  • GERD, gastro-oesophageal reflux disease
  • PPI, proton pump inhibitor
  • NERD, non-erosive reflux disease
  • ERD, erosive reflux disease
  • CLE, columnar lined oesophagus
  • SCJ, squamo–columnar junction
  • OGJ, oesophago–gastric junction
  • CK, cytokeratin
  • GERD
  • Helicobacter pylori
  • intestinal metaplasia

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.