Evaluation of the Relationship Between Gastroesophageal Reflux Disease and Helicobacter Pylori

INTRODUCTION: Helicobacter pylori (HP) is a gram-negative, microaerophilic bacterium that causes stomach infections. Gastroesophageal Reflux Disease (GERD) is one of the most common gastrointestinal disorders in the population, and its relationship with HP infection is still controversial. Although there are some articles in the literature that support the onset of esophagitis in patients with HP, a clear causal relationship between GERD and HP infection has not yet been established. The aim of this study is to evaluate the relationship between GERD and HP infection
METHODS: The files and gastroscopy reports of 1549 patients who underwent upper GIS endoscopy in the Gastroenterology Unit were evaluated. In addition to clinical features, 536 patients endoscopically diagnosed with GERD were included in the study. Endoscopy and pathology reports of 536 patients diagnosed with GERD were evaluated and analyzed for HP, esophagitis and intestinal metaplasia.
RESULTS: HP positivity was found in 229 (42,72%) of 536 patients diagnosed with GERD. Esophagitis was detected in 7,42% of patients with HP positive, and 13,35% of patients with HP negative had esophagitis. The frequency of esophagitis was found to be statistically significantly lower in those with positive HP (p=0,026).
DISCUSSION AND CONCLUSION: We found that patients with negative HP had significantly frequent reflux-esophagitis. This finding was consistent with the literature supporting the opposite relationship between HP and reflux-esophagitis. In the light of the knowledge obtained from the literature, it is thought that HP eradication in all patients with GERD will not reduce symptoms or may increase it.

Gastroözofageal Reflü Hastalýðý ve Helicobacter Pylori Ýliþkisinin Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Helicobacter pylori (HP) midede enfeksiyona neden olan gram negatif mikroaerofilik bir bakteri türüdür. Gastroözofageal Reflü Hastalýðý (GÖRH) toplumdaki en yaygýn gastrointestinal rahatsýzlýklardan biridir ve HP enfeksiyonu ile arasýndaki iliþki ise hala tartýþma konusudur. Literatürde, HP ile enfekte olan hastalarda özofajit baþlangýcýný destekleyen bazý makaleler olmasýna raðmen, GÖRH ve HP enfeksiyonu arasýnda net bir nedensel iliþki henüz kurulmamýþtýr. Bu çalýþmanýn amacý, GÖRH ile HP enfeksiyonu arasýndaki iliþkiyi deðerlendirmektir.
YÖNTEM ve GEREÇLER: Dr.Lütfi Kýrdar Kartal EAH Gastroenteroloji Ünitesinde üst GÝS endoskopisi yapýlan 1549 hastanýn dosyalarý ve gastroskopi raporlarý deðerlendirildi. Klinik özelliklerin yaný sýra endoskopik olarak GÖRH tanýsý koyulmuþ 536 hasta çalýþmaya dahil edildi. GÖRH tanýsý konulmuþ 536 hastanýn endoskopi ve patoloji raporlarý taranarak HP, özofajit ve intestinal metaplazi açýsýndan analiz edildi.
BULGULAR: GÖRH tanýsý konan 536 hastanýn 229’unda (%42,72) HP pozitifliði saptandý. HP pozitif olan hastalarýn %7,42’sinde özofajit saptandý, HP negatif olan hastalarýn ise %13,35’inde özofajit vardý. HP pozitif olanlarda özofajit sýklýðý istatiksel olarak anlamlý düþük bulundu (p=0,026).
TARTIÞMA ve SONUÇ: HP negatif olan hastalarda anlamlý derecede sýk reflü-özofajit olduðunu gördük. Bu bulgu HP ile reflü-özofajit arasýndaki zýt iliþkiyi destekleyen literatür ile uyumluydu. Literatürden edinilen bilgi birikimi ýþýðýnda GÖRH olan tüm hastalarda HP eradikasyonunun, bir grup hastada semptomlarý geriletmeyeceði belki de arttýrabileceði düþünülmektedir.