The Relation Between H. Pylori And Gastroesophageal Reflux Disease

Objective: The relation between Helicobacter pylori(H. pylori)infection and gastroesophageal reflux disease(GERD) hasn't been identified. As the literature reported H.pylori may protect gastroesophageal reflux disease(GERD) by increaseing lower esophageal sphincter (LES) pressure and reducing gastric acid, but there were some opposite reports. This study compared esophaguseal motor functions and esophaguseal acid exposure in H.pylori positive GERD and H.pylori negative GERD, in order to elucidate the relation between H.pylori and GERD, and to provide reference for clinical management of GERD. Methods: 64 patients diagnosed GERD were divided into two groups: H.pylori positive and negative groups. The H.pylori positive were 37, The H.pylori negative were 27. Antacids and prokinetic agents were discontinued for 7 days prior to the study. Esophageal manometry and 24-hour pH monitoring were performed by a eight-lumen catheter hydrocapillary perfusion system (PC Polygraf HR, Sweden) and a portable digital pH recorder (Digitrapper MK III,CTD-SYNECTICS, Sweden). Results: ①There were no significant differences in age, body index in H.pylori positive and negative groups (P>0.05). ②There were no significant differences in lower esophageal sphincter (LES) pressure (9.0 vs 9.2, P>0.05) and longitude (1.8 vs 1.7, P>0.05) between H.pylori positive and negative groups, so do in the esophageal body motor functions (P>0.05) . ③The DeMeester score (43 vs 44.7, P>0.05), the total percent of reflux time (7.6 vs 8.0, P>0.05), the total number of reflux episodes (156 vs 176 , P>0.05), the number of reflux episodes lasting for more than 5 min (4 vs 6, P>0.05) and the duration of longest reflux episode (20.5 vs 22.5, P>0.05) had no significant difference between H.pylori positive and negative groups.④The lower esophageal-spldncter (LES) pressure(9.1士1.88mmHg),were lower than that in normal persons, but have no correlation with DeMeester score(r=0.130,P=0.304). Conclusions: ①H.pylori infection may have no effect on LES and esophaguseal body motor functions in GERD;②H.pylori infection may have no effect on acid exposure in GERD;③This research indicate that there is no obviously relationship between H.pylori infection and the occurrence of GERD.