Article

Increased gastric acid secretion after Helicobacter pylori eradication may be a factor for developing reflux oesophagitis.

Department of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Alimentary Pharmacology & Therapeutics (impact factor: 3.77). 07/2001; 15(6):813-20.
Source: PubMed

ABSTRACT The role of acid secretion in reflux oesophagitis which may develop after H. pylori eradication is not well known.
To investigate the participation of altered gastric acid secretion and the presence of hiatal hernia in the development of reflux oesophagitis after eradication therapy for H. pylori.
A total of 105 patients with H. pylori infection, but without reflux oesophagitis at the time of eradication therapy, were followed prospectively for 7 months after the clearance of this microorganism. Gastric acid secretion was assessed by endoscopic gastrin test, and the presence of hiatal hernia by endoscopy.
Reflux oesophagitis developed in 11 out of 105 (10.5%) patients when examined at 7 months after the eradication therapy. The incidence was correlated significantly with the increase in gastric acid secretion after the eradication of H. pylori, and was significantly higher in the patients with hiatal hernia (20%) than in those without it (0%).
Increased acid secretion after H. pylori eradication is an important risk factor of reflux oesophagitis, especially in patients with hiatal hernia.

0 0
 · 
0 Bookmarks
 · 
19 Views
  • Source
    Article: Helicobacter pylori and oesophageal cancer--not always protective.
    Gut 05/2007; 56(4):457-9. · 10.11 Impact Factor
  • Article: Improvement of reflux symptom related quality of life after Helicobacter pylori eradication therapy.
    [show abstract] [hide abstract]
    ABSTRACT: The relationship between Helicobacter pylori (H. pylori) eradication therapy and the risk of developing gastroesophageal reflux disease (GERD) is controversial. We investigated the influence of H. pylori eradication on the risk of GERD by focusing on the quality of life (QOL) and evaluating reflux symptoms. Patients with H. pylori infection were administered triple therapy for H. pylori eradication. At 3 months and 1 year after the eradication therapy, surveys were conducted to determine the health-related QOL by quality of life in reflux and dyspepsia-Japanese version, (QOLRAD-J) and the severity of GERD symptoms by Carlsson-Dent questionnaire (CDQ). Forty patients were included in the analysis. Although no significant changes of these scores were apparent 3 months after H. pylori eradication, the QOLRAD-J and CDQ scores were significantly improved after 1 year. The degree of improvement was even more marked in cases with initially low scores. In conclusion, improved GERD-related QOL and reflux symptoms were noted 1 year after H. pylori eradication therapy. In addition, the degree of improvement was more marked in cases with severe reflux symptoms.
    Journal of Clinical Biochemistry and Nutrition 03/2013; 52(2):172-8. · 1.98 Impact Factor
  • Source
    Article: Does Helicobacter pylori infection protect against esophageal diseases in Asia?
    [show abstract] [hide abstract]
    ABSTRACT: The speculations on the protective role of Helicobacter pylori against gastroesophageal reflux disease (GERD) originated from epidemiological observations. These studies have shown that the rising trend of GERD is coincident with declining prevalence of H. pylori and peptic ulcer disease in Asia. Furthermore, most case-control and population-based studies suggest a negative association between H. pylori infection and GERD. It is generally believed that the preponderance of cagA+ and vacA+ virulent strains and proinflammatory interleukin-1 beta polymorphism increase the risk of hypochlohydria and protects against the development of GERD in Asian population. Recovery of gastric acid secretion and emergence of reflux esophagitis has been reported after H. pylori eradication in patients with corpus gastritis and atrophic gastritis. Recent studies have also reported that H. pylori eradication leads to recovery of ghrelin secreting cells in the gastric corpus and a rise in plasma ghrelin levels, which may contribute to obesity through its appetite-stimulating action and predispose to GERD. The prevalence of H. pylori infection is generally lower in younger Asians who enjoy improved socioeconomic status and sanitation compared with their older counterparts. The Asian population is probably facing a rising generation with high gastric acid and ghrelin secretion rates. These physiological changes may contribute to increased dietary calorie intake, obesity and increased prevalence of GERD.
    Indian Journal of Gastroenterology 08/2011; 30(4):149-53.

Keywords

7 months
 
acid secretion
 
clearance
 
endoscopic gastrin test
 
eradication
 
eradication therapy
 
gastric acid secretion
 
H. pylori
 
H. pylori eradication
 
H. pylori infection
 
hiatal hernia
 
Increased acid secretion
 
microorganism
 
patients
 
reflux oesophagitis
 
risk factor
 

T Koike