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GERD and H. pylori: is there a link?
1Department of Gastroenterology, Center for Swallowing and Esophageal Disorders, The Cleveland Clinic Foundation, OH 44195, USA.
Seminars in Gastrointestinal Disease
|February 24, 2001
Summary
Helicobacter pylori infection may protect against gastroesophageal reflux disease (GERD) and its complications, despite declining infection rates. This protective effect is linked to reduced refluxate potency in certain gastritis cases.
Area of Science:
- Gastroenterology
- Epidemiology
- Microbiology
Background:
- Rising incidence of gastroesophageal reflux disease (GERD) and esophageal adenocarcinoma contrasts with declining peptic ulcer disease and gastric cancer.
- Simultaneous decrease in Helicobacter pylori infection suggests a potential link to these opposing epidemiological trends.
Purpose of the Study:
- To explore the complex relationship between Helicobacter pylori infection and GERD.
- To investigate the potential protective role of H. pylori against GERD development and complications.
- To examine the implications of H. pylori infection on current GERD treatment strategies.
Main Methods:
- Review of recent epidemiological data on GERD, gastric cancer, and H. pylori infection.
- Analysis of proposed mechanisms for H. pylori's potential protective effect against GERD.
- Evaluation of the impact of H. pylori status on proton pump inhibitor (PPI) therapy efficacy and safety.
Main Results:
- H. pylori infection does not cause GERD but may protect susceptible individuals.
- The primary protective mechanism involves reduced gastric refluxate potency in corpus-predominant gastritis.
- H. pylori status influences PPI efficacy and carries risks like gastric atrophy during long-term therapy.
Conclusions:
- A complex, incompletely understood relationship exists between H. pylori infection and GERD.
- H. pylori eradication may alter GERD treatment considerations.
- Further research is needed to fully elucidate the interplay between H. pylori and GERD.