Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Patients with Helicobacter pylori infection have less severe gastroesophageal reflux disease: a study using endoscopy, 24-hour gastric and esophageal pH metry
Ist Teil von
Indian journal of gastroenterology, 2011-02, Vol.30 (1), p.12-21
Ort / Verlag
India: Springer-Verlag
Erscheinungsjahr
2011
Quelle
Free E-Journal (出版社公開部分のみ)
Beschreibungen/Notizen
Background and aim
The relationship between gastroesophageal reflux disease (GERD) and
Helicobacter pylori
is controversial. We evaluated endoscopic, 24-h gastric and esophageal acid profile among patients with GERD in relation to
H. pylori,
as the latter might alter gastric acid secretion.
Methods
Patients with GERD (
n
= 123), who were not on acid-suppressive drugs, and had not received anti-
H. pylori
therapy, underwent gastroduodenoscopy and tests for
H. pylori
detection. Esophageal manometry, 24-h pH metry, serum pepsinogen-I (PG-I), PG-II and gastrin-17 ELISA were done in all these patients. Univariate and multivariate analyses were performed to assess independent predictors for erosive esophagitis (EE).
Results
Of 123 patients (mean age 40.5 [13.1] years, 85 [69.1%] men), 59 (47.9%) had
H. pylori
infection. EE was more common in
H. pylori
non-infected than infected (49 vs. 32,
p
< 0.001). Among patients older than 40 years, absence of
H. pylori
was associated with lower esophageal pH and longer reflux (
p
= 0.02 and
p
< 0.001, respectively). PG-I/PG-II ratio was lower in
H. pylori
infected subjects (
p
< 0.001). In patients with higher LA grade of esophagitis, elevated PG-I levels and PG-I/PG-II ratio were associated with more acidic stomach (
p
= 0.04 and
p
= 0.01, respectively). Multivariate analyses showed low gastrin-17 (
p
= 0.016), higher age (
p
= 0.013), hiatus hernia (
p
= 0.004) and absence of
H. pylori
(
p
= 0.03) were independent predictors for risk of EE.
Conclusion
H. pylori
infection is associated with less acidic stomach and less severe GERD. Low gastrin-17, higher age, hiatus hernia and absence of
H. pylori
were the best predictors for EE risk.