helicobacter pylori eradication improves acid reflux and esophageal motility in patients with Gastroesophageal Reflux Disease and antral gastritis

Introduction: The relationship between Ηelicobacter pylori (hp) gastritis, the most common infection worldwide and Gastroesophageal Reflux Disease (GERD), a major health problem in Western Countries, remains controversial. AIM: To investigate the association between hp infection and GERD and the impact of hp eradication on esophageal acid exposure and esophageal motility in hp-positive patients with GERD. Methods: Twenty seven hp-positive (group I) and 20 hp-negative (group II) patients with GERD underwent endoscopy-biopsy, esophageal manometry and 24-hour ph-metry. All group I patients received eradication treatment and six months later they were re-evaluated with 24-hour phmetry, esophageal manometry and endoscopy-biopsy. Results: There were no significant differences between the two groups regarding sex, age, grade of esophagitis, manometric and ph-metry findings. All hp-positive patients had antrum predominant gastritis. In all group I patients’ eradication of hp was successful. Gastritis and esophagitis were healed in all patients. The mean lower oesophageal Sphincter Pressure (loSP) showed a significant increase of 11.7 mmhg before and 12.48 mmhg after eradication (p<0.04). A significant decrease in DeMeester score was observed (mean score 62.92 before versus 41.88 after eradication (p<0.01). Conclusions: 1. In patients with GERD the presence of hp has no impact on manometric and ph-metry findings. 2 The eradication of hp infection results in increase in loSP with a consequent decrease in esophageal acid exposure.