H. pylori Eradication Prevents the Progression of Gastric Intestinal Metaplasia in Reflux Esophagitis Patients Using Long-Term Esomeprazole

Yang, Hsiao Bai; Sheu, Bor–Shyang; Wang, Shin Tar; Cheng, Hsiu–Chi; Chang, Wei-Lun; Chen, Wei-Yiing

doi:10.1038/ajg.2009.172

Cited by 45 publications

(45 citation statements)

References 29 publications

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“…Eradication of H. pylori induces regression of gastritis and possibly of atrophy without stopping PPIs [116,117]. However, there is no evidence of an increased incidence of gastric cancer related to PPI use either with or without H. pylori [118,119].…”

Section: Cq: Is An Acid Suppressant Effective For the Treatment Of Gerd?mentioning

confidence: 97%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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As an increase in gastroesophageal reflux disease (GERD) has been reported in Japan, and public interest in GERD has been increasing, the Japanese Society of Gastroenterology published the Evidence-based Clinical Practice Guidelines for GERD (1st edition) in 2009. Six years have passed since its publication, and there have been a large number of reports in Japan concerning the epidemiology, pathophysiology, treatment, and Barrett's esophagus during this period. By incorporating the contents of these reports, the guidelines were completely revised, and a new edition was published in October 2015. The revised edition consists of eight items: epidemiology, pathophysiology, diagnosis, internal treatment, surgical treatment, esophagitis after surgery of the upper gastrointestinal tract, extraesophageal symptoms, and Barrett's esophagus. This paper summarizes these guidelines, particularly the parts related to the treatment for GERD. In the present revision, aggressive proton pump inhibitor (PPI) maintenance therapy is recommended for severe erosive GERD, and on-demand therapy or continuous maintenance therapy is recommended for mild erosive GERD or PPI-responsive non-erosive GERD. Moreover, PPI-resistant GERD (insufficient symptomatic improvement and/or esophageal mucosal break persisting despite the administration of PPI at a standard dose for 8 weeks) is defined, and a standard-dose PPI twice a day, change in PPI, change in the PPI timing of dosing, addition of a prokinetic drug, addition of rikkunshito (traditional Japanese herbal medicine), and addition of histamine H2-receptor antagonist are recommended for its treatment. If no improvement is observed even after these treatments, pathophysiological evaluation with esophageal impedancepH monitoring or esophageal manometry at an expert facility for diseases of the esophagus is recommended.

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Section: Cq: Is An Acid Suppressant Effective For the Treatment Of Gerd?mentioning

confidence: 97%

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

et al. 2016

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“…Indeed, at least, H. pylori eradication seems to decrease the progression of gastric intestinal metaplasia [236,242,243]. However, even after successful H. pylori eradication, gastric cancer still develops in the context of intestinal metaplasia [235,239].…”

Section: Surveillancementioning

confidence: 98%

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

et al. 2011

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Atrophic gastritis, intestinal metaplasia, and epithelial dysplasia of the stomach are common and are associated with an increased risk for gastric cancer. In the absence of guidelines, there is wide disparity in the management of patients with these premalignant conditions. The European Society of Gastrointestinal Endoscopy, the European Helicobacter Study Group, the European Society of Pathology, and the Sociedade Portuguesa de Endoscopia Digestiva have therefore combined efforts to develop evidence-based guidelines on the management of patients with precancerous conditions and lesions of the stomach. A multidisciplinary group of 63 experts from 24 countries developed these recommendations by means of repeat online voting and a meeting in June 2011 in Porto, Portugal. The recommendations emphasize the increased cancer risk in patients with gastric atrophy and metaplasia and the need for adequate staging in the case of high-grade dysplasia, and they focus on treatment and surveillance indications and methods.

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“…Un estudio en pacientes tratados de manera crónica con IBP por esofagitis constató que hasta un 30% de los pacientes que presentaban infección por H. pylori y recibían IBP desarrollaban gastritis atrófica tras 5 años de tratamiento, mientras que ni los controles no infectados tratados con IBP ni los controles infectados por H. pylori que no recibieron IBP desarrollaron cambios de gastritis atrófica durante el período del estudio 99 . Por otro lado, Yang et al aleatorizaron pacientes con esofagitis tratados con esomeprazol a recibir o no tratamiento erradicador de H. pylori 100 . El grupo que recibió tratamiento erradicador mostró una tasa de regresión más alta y una tasa de progresión más baja tanto de atrofia gástrica como de metaplasia intestinal.…”

Section: Recomendación A9unclassified

III Conferencia Española de Consenso sobre la infección por Helicobacter pylori

Gisbert¹,

Calvet²,

Bermejo³

et al. 2013

Gastroenterología y Hepatología

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H. pylori Eradication Prevents the Progression of Gastric Intestinal Metaplasia in Reflux Esophagitis Patients Using Long-Term Esomeprazole

Abstract: In patients using long-term esomeprazole for reflux esophagitis, screening for and eradicating H. pylori infection are necessary in order to limit the progression or cause the regression of gastric precancerous changes.

Cited by 45 publications

References 29 publications

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Evidence-based clinical practice guidelines for gastroesophageal reflux disease 2015

Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa de Endoscopia Digestiva (SPED)

III Conferencia Española de Consenso sobre la infección por Helicobacter pylori

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