Helicobacter pylori eradication improves pre-existing reflux esophagitis in patients with duodenal ulcer disease

Kuniharu Ishiki, Motowo Mizuno, Susumu Take, Yasuhiro Nagahara, Tomowo Yoshida, Kazuhide Yamamoto, Hiroyuki Okada, Kenji Yokota, Keiji Oguma, Yasushi Shiratori

Research output: Contribution to journalArticlepeer-review

38 Citations (Scopus)


Background & Aims: There has been significant controversy over the relationship between Helicobacter pylori infection and reflux esophagitis. We investigated the effects of eradicating H. pylori on the reflux esophagitis found in patients with peptic ulcers. Methods: Prospective posteradication evaluations were conducted yearly in 162 H. pylori-positive patients who had reflux esophagitis together with peptic ulcer disease (4 women and 158 men, mean age = 49.1 yr). The Los Angeles classification of the patients' esophagitis was: grade A, 90; grade B, 63; and grade C, 9. The follow-up evaluations began 1 to 2 months after completion of the eradication treatment (mean time of follow-up = 22 mo), and consisted of endoscopy and an interview focusing on heartburn. Results: Six patients were withdrawn from the study because of adverse drug reactions or a failure to regularly keep their appointments. After eradication therapy, we observed endoscopically that reflux esophagitis had improved in 87 (55.8%) of the 156 patients. The improvement rate was significantly higher in patients cured of infection (60.8%) than in those with persistent H. pylori infection (38.9%) (P = 0.04). Body mass index (odds ratio = 0.86, 95% confidence interval [CI] = 0.76-0.97), cure of infection (3.68, 95% CI = 1.56-8.69), the absence of a hiatal hernia (3.90, 95% CI = 1.83-8.28), and an ulcer located in the duodenum (2.75, 95% CI = 1.33-5.70) were identified as significant independent factors for the improvement of reflux esophagitis. Conclusions: In patients with reflux esophagitis associated with duodenal ulcer, a significant improvement in pre-existing reflux esophagitis was noted after H. pylori eradication.

Original languageEnglish
Pages (from-to)474-479
Number of pages6
JournalClinical Gastroenterology and Hepatology
Issue number6
Publication statusPublished - Jun 2004


  • CI
  • GERD
  • PPI
  • UBT
  • confidence interval
  • gastroesophageal reflux disease
  • proton pump inhibitor
  • urea breath test

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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