Six-year follow-up afterHelicobacter pylori eradication in peptic ulcer disease

O'Connor, H.J.; Stewart, Charles F.; Walsh, Robert D.; McGee, C. N.; Flynn, Bridget

doi:10.1007/bf03167715

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Thirteen 8, 13, 14, 31–36, 39–42 evaluated the effect of presence or absence of H. pylori on reflux oesophagitis in terms of severity, healing and relapse (Appendix 2). Seven studies 43–49 did not meet our eligibility criteria and were excluded (Appendix 3). Appendices are available on request.…”

Section: Resultsmentioning

confidence: 99%

The effect of Helicobacter pylori and its eradication on gastro‐oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis

Raghunath

Hungin

Wooff

et al. 2004

Aliment Pharmacol Ther

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SUMMARYBackground: The effect of Helicobacter pylori in provoking or protecting against gastro-oesophageal reflux disease is unclear and studies have given conflicting results. Recent guidelines recommend H. pylori eradication in patients on long-term proton pump inhibitors. Aim: To ascertain the effect of H. pylori eradication on gastro-oesophageal reflux disease outcomes (reflux oesophagitis and heartburn) in patients with duodenal ulcer disease, and to ascertain the effect of H. pylori infection on reflux oesophagitis concerning heartburn, pH, severity, healing and relapse rates. Methods: A systematic review of electronic databases was undertaken to September 2003. Experts in the field, pharmaceutical companies and journals were contacted about unpublished trials. Studies were

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Section: Resultsmentioning

confidence: 99%

The effect of Helicobacter pylori and its eradication on gastro‐oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis

Raghunath

Hungin

Wooff

et al. 2004

Aliment Pharmacol Ther

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“…Its importance, however, lies not only in its prevalence, but also in its adverse effects on quality of life, potential for morbidity and mortality, and high rate of health care utilization [3,4]. Recent data suggest that the duration and severity of untreated GERD are associated with the development of Barrett's esophagus and esophageal adenocarcinoma [5].…”

Section: Introductionmentioning

confidence: 99%

A Retrospective, Case-Control Pilot Study of the Natural History of Pediatric Gastroesophageal Reflux

et al. 2007

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The duration of gastroesophageal reflux disease (GERD) is an important factor in the development of esophageal complications. The objective of this study was to examine in a retrospective, case-controlled manner the prevalence of GERD in adults who were diagnosed with GERD in infancy or early childhood. Infants and children with nonsyndromic GERD diagnosed by an experienced pediatric gastroenterologist from 1976 to 1980 and control subjects seen for well-child care from 1980 to 1985 were included in this study. The subjects were located and contacted by telephone or mail and administered a brief structured questionnaire relating to their current history of GERD. GERD-A was defined as weekly heartburn or regurgitation of any severity, and GERD-B was defined as monthly heartburn or regurgitation greater than mild in severity. Sixty-five participants (31 patients and 34 controls) returned completed questionnaires and were subdivided into the three study groups as follows: Infant (15), Child (16), and Control (34). The prevalence of adulthood GERD-A was 13, 31, and 21% in the Infant, Child, and Control groups, respectively. Similarly, the prevalence of adulthood GERD-B was 20%, 44%, and 24%, respectively. The Child group tended to report more severe heartburn than the other groups. The Infant group tended to report more frequent regurgitation, and the Child group also reported a higher prevalence of nocturnal heartburn and more frequent use of GERD medications, although these were not statistically significant. These data suggest that pediatric GER is a heterogeneous disorder and that GERD occurring after infancy may be more predictive of the presence of GERD during adulthood. Longitudinal follow-up of a larger number of children is needed to answer the question of when classic adulthood GERD begins.

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The Recurrence of Helicobacter pylori Infection: Incidence and Variables Influencing It. A Critical Review

Gisbert

2005

Am J Gastroenterology

114

119

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The rate of H. pylori recurrence after eradication of the microorganism seems to be relatively low, at least in developed countries, where the mean annual reinfection rate is of approximately 3% per patient-year of follow-up, although the risk of reinfection in some developing regions is considerably higher. Several findings suggest that recrudescence rather than reinfection is likely to be responsible for most cases of recurrence: (i) the recurrences decrease with time and decline sharply after the first year, and (ii) studies using molecular fingerprinting techniques (polymerase chain reaction [PCR]) confirm that the identified microorganisms (before and after therapy) are usually genetically identical. The lower the efficacy of an antibiotic therapy, the greater the likelihood that recurrence occur, again suggesting that in these cases temporary "clearance" has been achieved rather than true eradication. The value of the (13)C-urea breath test after treatment is higher in those patients who suffer a recurrence; therefore, selection of a lower cut-off value may be helpful to maintain the diagnostic accuracy of posttreatment breath test, and thus preventing recrudescences. The observation of a pattern of histological (active) gastritis without the concomitant finding of H. pylori must raise the suspicion of a diagnostic error. Some studies suggest that recurrence is relatively infrequent, even if the patient's spouse is H. pylori-positive, suggesting that the patient's partner does not act as a reservoir for the reinfection. However, other investigators achieve contrary results, although a common exogenous source of H. pylori (for both partner's infection and patient's reinfection) cannot be ruled out. The oral cavity may be a potential source for recrudescence of gastric infection after successful therapy. When peptic ulcer reappears (sometimes with bleeding recurrence) or gastric MALT (mucosa-associated lymphoid tissue) lymphoma relapses after previous H. pylori eradication, recolonization of the gastric mucosa by the organism has almost always occurred.

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Six-year follow-up afterHelicobacter pylori eradication in peptic ulcer disease

Abstract: Despite a low H. pylori recurrence rate, longterm dyspeptic symptoms were common in peptic ulcer patients after H. pylori eradication. The symptoms are mainly reflux in type and require anti-secretory therapy in only a minority of patients.

Cited by 3 publications

References 17 publications

The effect of Helicobacter pylori and its eradication on gastro‐oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis

The effect of Helicobacter pylori and its eradication on gastro‐oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis

A Retrospective, Case-Control Pilot Study of the Natural History of Pediatric Gastroesophageal Reflux

The Recurrence of Helicobacter pylori Infection: Incidence and Variables Influencing It. A Critical Review

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