High prevalence of reflux symptoms in duodenal ulcer patients who develop gastro-oesophageal reflux disease after curing Helicobacter pylori infection

Randomised controlled trial of effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux: Bristol helicobacter project

“…H pylori infection usually causes a predominantly antral gastritis, which results in a net increase in acid secretion 16. In people with an incompetent antireflux mechanism, this would increase exposure of the lower oesophagus to acid, increasing the prevalence of heartburn 4 5. Our findings that H pylori is associated with an increased prevalence of heartburn and that H pylori eradication treatment reduces the risk of patients with acid reflux developing heartburn support this hypothesis.…”

Empirical prescribing for dyspepsia: randomised controlled trial of test and treat versus omeprazole treatment

“…Case-control studies have shown that eradication of H pylori may result in an increased incidence of gastro-oesophageal reflux disease 18. More recent data, however, do not support this hypothesis 12 19. We believe that the four week proton pump inhibitor treatment is more efficient than the eradication treatment in terms of healing oesophageal erosions and persistence of symptomatic remission.…”

“…We excluded patients with reflux symptoms from our study, as H pylori does not have a causative role in gastro-oesophageal reflux disease. Our data highlight some of the difficulties in making the clinical diagnosis of reflux disease 12 17…”

“…We assessed symptoms at baseline by means of a previously validated questionnaire 12. We stratified the randomisation procedure to take into account sex, tobacco use, and alcohol intake in the previous two years (social intake ≤ 80 g/day in men, ≤ 50 g/day in women; excess intake > 80 g/day in men, > 50 g/day in women).…”

Randomised controlled trial of effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux: Bristol helicobacter project

“…3 Later studies, with varying methods, have produced conflicting results; some showed an increase or unmasking of reflux oesophagitis, [4][5][6] others reported no effect, [7][8][9] and some even found a benefit. [10][11][12][13] Randomised controlled trials generally provide more reliable information than observational studies.…”