Effect of Helicobacter pylori Infection and Its Eradication on Reflux Esophagitis and Reflux Symptoms

Nam, Su Youn; Choi, Il Ju; Ryu, Kum Hei; Kim, Jae Hak; Kim, Chan Gyoo; Nam, Byung–Ho

doi:10.1038/ajg.2010.251

Cited by 61 publications

(59 citation statements)

References 65 publications

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“…In contrast, no such risk has been reported by Western studies 45. However, two recent large-scale cohort studies in Korea produced inconsistent results 46 47. In addition, our previous endoscopic surveys revealed that GORD was rare and oesophageal adenocarcinoma was uncommon in Linqu,48 therefore, the risk of increasing GORD and oesophageal adenocarcinoma may be minor in comparison with the benefits of a 20–40% of reduction in GC incidence in Linqu.…”

Section: Discussionmentioning

confidence: 90%

A large randomised controlled intervention trial to prevent gastric cancer by eradication ofHelicobacter pyloriin Linqu County, China: baseline results and factors affecting the eradication

Pan

Lian

Gerhard

et al. 2015

Gut

159

121

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Objective To clarify the full range of benefits and adverse consequences of Helicobacter pylori eradication as a strategy for gastric cancer prevention, the community-based intervention trial was launched in Linqu County, China. Design A total of 184 786 residents aged 25-54 years were enrolled in this trial and received 13 C-urea breath test. H. pylori positive participants were assigned into two groups, either receiving a 10-day quadruple anti-H. pylori treatment or lookalike placebos together with a single dosage of omeprazole and bismuth. Results The prevalence of H. pylori in trial participants was 57.6%. A total of 94 101 subjects completed the treatment. The overall H. pylori eradication rate was 72.9% in the active group. Gender, body mass index, history of stomach disease, baseline delta over baselinevalue of 13 C-urea breath test, missed medication doses, smoking and drinking were independent predictors of eradication failure. The missed doses and high baseline delta over baseline-value were important contributors in men and women (all P trend <0.001). However, a doseresponse relationship between failure rate and smoking or drinking index was found in men (all P trend <0.001), while high body mass index (P trend <0.001) and history of stomach disease were significant predictors in women. The treatment failure rate increased up to 48.8% (OR 2.87, 95% CI 2.24 to 3.68) in men and 39.4% (OR 2.67, 95% CI 1.61 to 4.42) in women with multiple factors combined. Conclusions This large community-based intervention trial to eradicate H. pylori is feasible and acceptable. The findings of this trial lead to a distinct evaluation of factors influencing eradication that should be generally considered for future eradication therapies. Trial registration number ChiCTR-TRC-10000979 in accordance with WHO ICTRP requirements. INTRODUCTIONHelicobacter pylori (H. pylori) is a recognised cause of chronic gastritis and peptic ulcer disease, and may play an important role in the etiology of Significance of this studyWhat is already known on this subject?▸ Gastric cancer is a global public health burden, nearly one million new cases are diagnosed each year worldwide, of which 42% cases occur in China. ▸ Helicobacter pylori infection is the main risk factor for gastric cancer, and it was classified as a class I carcinogen for gastric cancer by International Agency for Research on Cancer in 1994. ▸ The Shandong Intervention Trial launched in Linqu in 1995 yielded a 39% reduction in gastric cancer incidence rate after 15 years follow-up. ▸ Benefits and adverse consequences of strategy for gastric cancer prevention by eradication of H. pylori are still in concern in the community setting.What are the new findings?▸ The large community-based intervention trial to eradicate H. pylori is feasible and acceptable in a high-risk area of gastric cancer in China. It gained an elimination of 72.9% of H. pylori in such community intervention trial without severe side effects among all the subjects during the entire 30-month trial pe...

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Section: Discussionmentioning

confidence: 90%

A large randomised controlled intervention trial to prevent gastric cancer by eradication ofHelicobacter pyloriin Linqu County, China: baseline results and factors affecting the eradication

Pan

Lian

Gerhard

et al. 2015

Gut

159

121

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“…The study of 10 102 healthy individuals from Korea [55] also suggested that eradication increased the incidence of erosive esophagitis to the level of H. pylori-negative individuals, and the protective effect of H. pylori infection on reflux esophagitis disappeared after successful eradication. With the analysis of case-control studies, our study found that patients with GORD had a lower prevalence of H. pylori infection, which indicates a protective effect of H. pylori infection on GORD.…”

Section: Discussionmentioning

confidence: 94%

“…CagA + strains induce more extensive epithelial cell injuries [69,72] and secrete more proinflammatory cytokines (such as interleukin-8) [69,73] with more intense infiltration of the gastric mucosa by neutrophils and mononuclear cells [72,74] and more rapid development of atrophic gastritis [75] and concomitant changes in gastric secretion [70]. Using visualized images of Congo red chromoendoscopy, Sekine et al [76] found lnoue et al [42] Kim et al [43] Levine et al [44] Malfertheiner et al [10] McColl et al [45] Murai et al [46] Take et al [15] Tsukada et al [47] Total (95% CI) Bytzer et al [49] Hamada et al [14] Harvey et al [51] Jonaitis et al [52] Kim et al [54] Malfertheiner et al [10] Moayyedi et al [53] Nam et al [55] Ott et al [50] Vakil et al [11] Wu et al [56] Total (95% CI) that the acid-secreting mucosa in the fundus expanded in most cases with fundic atrophic gastritis after H. pylori eradication, which could be responsible for the increase or 'recovery' in acid secretion after the eradication.…”

Section: Referencesmentioning

confidence: 98%

Meta-analysis

Xie¹,

Cui²,

Zheng³

et al. 2013

European Journal of Gastroenterology & Hepatology

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“…In their study of over 10,000 subjects, eradication of H. pylori also increased the prevalence of reflux esophagitis (odds ratio 2.34) [1]. Other studies have also supported this clinical relationship [2,3].…”

Section: Commentsmentioning

confidence: 85%

Helicobacter pylori: Is it a Complete Villain?

Coyle

2011

Curr Gastroenterol Rep

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Effect of Helicobacter pylori Infection and Its Eradication on Reflux Esophagitis and Reflux Symptoms

Cited by 61 publications

References 65 publications

A large randomised controlled intervention trial to prevent gastric cancer by eradication ofHelicobacter pyloriin Linqu County, China: baseline results and factors affecting the eradication

A large randomised controlled intervention trial to prevent gastric cancer by eradication ofHelicobacter pyloriin Linqu County, China: baseline results and factors affecting the eradication

Meta-analysis

Helicobacter pylori: Is it a Complete Villain?

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