Update on the role of H pylori infection in gastrointestinal disorders: GERD

16 Mar

GERDPossibly the most controversial issue of H pylori infection in gastrointestinal disorders is that of its relationship to GERD. The occurrence of de novo GERD following eradication of H pylori in patients with peptic ulcer disease has been observed in several reports, including a trial that prospectively examined the incidence of GERD in patients who received successful or unsuccessful eradication therapy for the management of duodenal ulcers. However, this evidence is largely anecdotal, and results are emerging to suggest that the incidence of GERD does not increase after eradication of H pylori. In the abovementioned trial conducted by McColl and colleagues, a possible benefit of eradication therapy was demonstrated in patients with GERD. Of the 86 patients in whom H pylori was successfully eradicated, 27 had GERD upon initial presentation. Interestingly, the proportion of patients who experienced resolution of GERD symptoms increased with time after successful eradication of H pylori; after more than two years of follow-up, 44% of these patients had experienced resolution of their symptoms. Of the 59 patients with no evidence of GERD before eradication therapy, only three developed de novo GERD following eradication of H pylori — an incidence rate similar to that of GERD in the general population. These results suggest that eradication of H pylori in patients with peptic ulcers does not induce de novo GERD and may, in fact, be implicated in the resolution of GERD symptoms. Until further assessments of the relationship between H pylori and GERD are available, the Canadian Consensus Guidelines do not advocate routine testing for the presence of H pylori in patients with GERD; however, eradication therapy may be offered on a case by case basis in patients with known H pylori infection. Get most advantageous deals ever – generic viagra online mastercard waiting for you round the clock.