Functional dyspepsia and helicobacter pylori (HP): Is eradication clinically relevant? a meta-analysis on the natural history of gastritis and gastric and duodenal ulcers (original) (raw)

2001, Digestive and Liver Disease

Backsmud and aim: To investiwte the incidence of retlux escphaxitis after Heliccbacter pylori (HP) &&&ion in patients witl~unccmplicated, Hp-associatedchronic gastritis during a lrmcntb follow up wricd. Material and methods: Afrer bistcdogically pmven Hp eradication, 113 pts (WF 61,52: &e-47*1 I; E gmup) without histological timI& of escphagitis (ES) at the time of emdication, were followed up for one year (I I*3 month), tbm reexamined by EGD-scopy with multiale bicosies. These data WETC conmated with those of 61 sex-and we-matched, Hp+ve, ~n&cd pts (contmls, C group) wit&t histclogical tindings of ES, endoscopically rpinvestigated after a similar follow-up paicd (12'4 month). Patients with atrcpbic gsstritis, pepric UlcSr, necplasia or pyloric stenosis have been excluded. Results: A biatal hernia (HH) ~8s found in 99 (57%) pts (64 E, 35 c: p=+.9). At the end of the follow up, ES was bistclcgically diagnosed in 28 (16%) pts (25 E, 3 C), with a greater incidence in eradicated pts (22% VI 5%; p=O.OW cdds ratio 5.49; 95%CL: 1.56-29.48). From pts of both gmup with H?I, bistcIogical tindings of ES were detect& in 25 (25%) pts (22 E, 3 C), with a significantly bigba incidence in eradicated pts (34% vs 6%; fl.01; cdds 5.59; 9WnCL.z I .46-31.22). No significant difference between gmups for incidence of ES was found in patients without HH (6% E vs 0% C, p=O.S). Conclusions: These results suggest that reflex cw&gitis may develop in some patients after Hp eradication for uncomplicated, Hp.associated chronic gastitis, probably because of an increased gastric acid secretion. The presence of a hiatal hernia may expose eradicated patients tc B higher nsk of developing escphagitis