Volume 40, Number 4, 350-360, DOI: 10.1007/s00535-004-1552-1

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Japanese Society of Gastroenterology

Influence of cure of Helicobacter pylori infection on gastric acidity and gastroesophageal reflux: study by 24-h pH monitoring in patients with gastric or duodenal ulcer

Takumi Fukuchi, Kiyoshi Ashida, Hiroshi Yamashita, Naomi Kiyota, Reiko Tsukamoto, Hajime Takahashi, Dai Ito and Ryousuke Nagamatsu

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Abstract

Background  

Whether or not the eradication of Helicobacter pylori is a risk factor for reflux esophagitis (RE) is a question at issue. To find an answer, it is necessary to clarify the influence of H. pylori eradication on the mechanism of RE.

Methods  

The authors investigated the influence of H. pylori eradication on gastric acidity and gastroesophageal reflux in ten gastric ulcer (GU) patients and ten duodenal ulcer (DU) patients by 24-h simultaneous determination of pH in the stomach and esophagus.

Results  

Though the results indicated enhanced gastric acidity in GU patients at night after H. pylori eradication, no such influence was observed in DU patients. No significant changes in gastroesophageal reflux occurred in GU or DU patients before and after H. pylori eradication. RE after H. pylori eradication occurred in only one patient, with GU. This patient had several risk factors for RE, such as obesity, male sex, and dietary habits to add to the increase in gastric acidity at night that occurred after H. pylori eradication. No increase in gastroesophageal reflux occurred in any DU patients or in the other GU patients that demonstrated enhanced gastric acidity at night after H. pylori eradication.

Conclusions  

The cure of H. pylori infection does not, by itself, cause RE in patients who have few other risk factors for RE.

Key words   H. pylori eradication - reflux esophagitis - gastric ulcer - duodenal ulcer - 24-h pH monitoring

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