Helicobacter pylori eradication improves acid reflux and esophageal motility in patients with Gastroesophageal Reflux Disease and antral gastritis

Authors T. Maris, A. Ilias, D. Kapetanos, A. Augerinos, P. Xiarhos, A. Gagalis, G. Kokozidis, E. Akriviadis, D. Koliouskas, M. Sion, G. Kitis.

Abstract

Introduction: The relationship between Ηelicobacter pylori (Hp) gastritis, the most common infection worldwide and Gastroesophageal Reflux Disease (GERD), a major health problem in Western Countries, remains controversial. AIM: To investigate the association between Hp infection and GERD and the impact of Hp eradication on esophageal acid exposure and esophageal motility in Hp-positive patients with GERD. Methods: Twenty seven Hp-positive (group I) and 20 Hp-negative (group II) patients with GERD underwent endoscopy- biopsy, esophageal manometry and 24-hour pH-metry. All group I patients received eradication treatment and six months later they were re-evaluated with 24-hour pHmetry, esophageal manometry and endoscopy-biopsy. Results: There were no significant differences between the two groups regarding sex, age, grade of esophagitis, manometric and pH-metry findings. All Hp-positive patients had antrum predominant gastritis. In all group I patients' eradication of Hp was successful. Gastritis and esophagitis were healed in all patients. The mean Lower Oesophageal Sphincter Pressure (LOSP) showed a significant increase of 11.7 mmHg before and 12.48 mmHg after eradication (p<0.04). A significant decrease in DeMeester score was observed (mean score 62.92 before versus 41.88 after eradication (p<0.01). Conclusions: 1. In patients with GERD the presence of Hp has no impact on manometric and pH-metry findings. 2 The eradication of Hp infection results in increase in LOSP with a consequent decrease in esophageal acid exposure.
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Original Articles