A) Meta-analysis: the relationship between Helicobacter pylori infection and gastro-oesophageal reflux disease.

Filippo Cremonini, Simona Di Caro, S. Delgado Aros, Antonia Sepulveda, Giovanni Battista Gasbarrini, Antonio Gasbarrini, M. Camilleri

Research output: Contribution to journalArticle

88 Citations (Scopus)

Abstract

BACKGROUND: The relationship between Helicobacter pylori infection and its treatment and gastro-oesophageal reflux disease (GERD) is controversial. AIMS: To establish if H. pylori infection is associated with the presence of GERD and if anti-H. pylori treatment leads to de novo GERD or rebound/exacerbation of GERD. METHODS: A search of MEDLINE and EMBASE databases was made. Pooled odds ratios (OR) were calculated for de novo GERD and rebound/exacerbated GERD after anti-H. pylori therapy in case-control studies and in therapeutic trials. RESULTS: Fourteen case-control studies and 10 clinical trials were included. Among case-control studies, pooled OR for the association between H. pylori negative status and GERD was 1.34 [95% confidence interval (CI) 1.15-1.55]. Among therapeutic trials, pooled OR for the association anti-H. pylori therapy - GERD was 2.54 (95% CI 1.92-3.37). The OR for de novo GERD was 3.25 (95% CI 2.09-5.33), and for rebound/exacerbated GERD was 2.39 (95% CI 1.75-3.34). Associations were higher among Asian studies than among North American and European studies. CONCLUSIONS: This meta-analysis shows significant association between absence of H. pylori infection and GERD symptoms, and a positive association between anti-H. pylori therapy and occurrence of both de novo and rebound/exacerbated GERD. The significance of these associations appears to have been inflated by the effect of single trials and by geographical variations.
Original languageEnglish
Pages (from-to)279-289
Number of pages11
JournalALIMENTARY PHARMACOLOGY & THERAPEUTICS
Publication statusPublished - 2003

Keywords

  • H Pylori
  • reflux

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