J Neurogastroenterol Motil.  2011 Jul;17(3):267-273.

Helicobacter pylori Serology Inversely Correlated With the Risk and Severity of Reflux Esophagitis in Helicobacter pylori Endemic Area: A Matched Case-Control Study of 5,616 Health Check-Up Koreans

• Chung SJ
• Lim SH
• Choi J
• Kim D
• Kim YS
• Park MJ
• Yim JY
• Kim JS
• Cho SH
• Jung HC
• Song IS

Abstract

BACKGROUND/AIMS
The role of Helicobacter pylori in gastroesophageal reflux disease remains still controversial and the effect of the organism on severity of reflux esophagitis have been rarely issued. The aim of this study was to investigate the relationship between H. pylori infection and reflux esophagitis, and especially the severity of reflux esophagitis.
METHODS
We performed a cross-sectional case-control study of 5,616 subjects undergoing both upper endoscopy and H. pylori serology during health Check-up (2,808 cases vs age- and sex-matched controls). Smoking, alcohol, body mass index and waist circum - ference were added to a multiple regression model.
RESULTS
Prevalence of H. pylori infection was lower in cases with reflux esophagitis than in controls (38.4% vs 58.2%, P < 0.001) and negative associations with H. pylori infection continued across the grade of esophagitis (46.7% in Los Angeles classification M [LA-M], 34.3% in LA-A or LA-B and 22.4% in LA-C or LA-D, P < 0.001). Positive serology for H. pylori independently reduced the risk of reflux esophagitis (adjusted OR, 0.44; 95% CI, 0.39-0.49). Notably, the negative associations continued across the grade of esophagitis with adjusted ORs of 0.63 in LA-M, 0.36 in LA-A or LA-B and 0.20 in LA-C or LA-D (P < 0.001).
CONCLUSIONS
In a age-sex matched Korean, H. pylori seropositivity was independently and inversely associated with the risk and severity of reflux esophagitis, suggesting the organism may have a protective role against gastroesophageal reflux disease.

Keyword

Esophagitis; Gastroesophageal reflux; Helicobacter pylori; Peptic; Risk factors

MeSH Terms

Body Mass Index
Case-Control Studies
Electrolytes
Endoscopy
Esophagitis
Esophagitis, Peptic
Gastroesophageal Reflux
Helicobacter
Helicobacter pylori
Los Angeles
Prevalence
Risk Factors
Smoke
Smoking
Electrolytes
Smoke