Association of helicobacter pylori infection with reflux esophagitis and Barrett esophgus / 中国综合临床

ABSTRACT

Objective To study the influence of anti-Helicobacter pylori therapy on reflux esophagitis (RE) and Barrett's esophagus (BE). Methods Two hundred and sixty-two patients including 177 patients with RE and 85 patients with BE were divided into 2 groups Group A,139 patients without Hp infection;Group B,123 patients with Hp infection, which was further divided into 2 groups (group B1 and group B2) randomly. The pa-tients in group A and B1 were treated with Losec 20 mg bid, domperidone 10 mg tid and colloidal bismuth pectin 100 mg tid for 8 weeks, group B2 were treated with 2 kinds of antibiotics which were chosen from 3 types of antibiot-ics including amoxicillin 500 mg bid, Clarithromycin 500 mg bid or tinidazole 500 mg bid for 2 weeks additional to the same treatment as group A and B1. Endoscopy, pathologic examination, 24 h esophagus pH value and bilirubin were measured before and after treatment. Results The overall rates of improvement on symptoms in the 3 groups were 95.0% (group A 97.8% (136/139), group B1 96.8% (60/62), group B2 98.4% (60/61)), which was significantly different from that before treatment (P < 0.05). However, the overall effect rates were not significantly different among the 3 groups (P > 0.05). The overall effect rate based on endoscopy examination in the RE patients 92.9% (78/84),91.8% (45/49) and 88.6% (39/44) in group A,B1 and B2,respectively,and the differences were statistically significant among the 3 groups (P <0.05). The overall effect rates in the BE patients were about 35.0%,which showed non-significant effect compared to that before treatment (P >0.05). 24 hrs esophagus PH value and bilirubin were significantly improved in the 3 groups (P < 0.05), whereas the difference among the 3 groups were not significant (P > 0.05). Conclusions RE and BE patients with HP infection could be treated with anti-Helicobacter pylori therapy. However, systematic therapy of anti gastric acid, prokinetics and mucosa protector must be performed simultaneously. This might be effective in preventing the development of RE and BE in short term. The long term effect is still uncertain and large scale, long term clinical studies are needed.