[Prevalence of Helicobacter pylori infection in patients with reflux esophagitis. A case-control study]

The association between Helicobacter pylori (Hp) infection and gastroesophageal reflux disease (GERD) has been extensively studied with controversial results. There is not sufficient information on this relationship in populations with high prevalence of Hp infection.

a) To know prevalence of Hp infection in patients with reflux esophagitis, b) to compare this prevalence in subjects with reflux esophagitis and without GERD, and c) to study the relationship between infection and the severity of esophagitis.

Patients with digestive symptoms were studied using a questionnaire, upper-gastrointestinal endoscopy, and rapid urease test. Two groups were conformed: cases (subjects with heartburn, acid regurgitations, and erosive esophagitis or Barrett's esophagus), and controls (subjects with epigastric pain, without heartburn, acid regurgitations, or erosive esophagitis). Prevalence of Hp infection, hiatal hernia and peptic ulcer disease was compared in both groups. The relationship between frequency of Hp infection and severity of esophagitis was analyzed.

Five hundred eighty three patients were studied (226 cases, 357 controls). Hp infection was detected in 65% of cases and 66% of controls (p = NS). Hiatal hernia was more frequently detected in patients with esophagitis; however, prevalence of peptic ulcer disease was similar in both groups. Proportion of Hp-infected patients was similar regardless of severity of esophagitis (Los Angeles grade A-B, 64%; grade C-D, 69%) and Barrett's esophagus, 63%; p = NS).

Prevalence of Hp infection in patients with reflux esophagitis is 65% and very similar in patients without GERD. No relationship was founded between Hp infection and severity of esophagitis.