Reflux Esophagitis After Eradication Of Helicobacter Pylori In Peptic Ulcer Patients: Impact Of Initial Corpus And Antral Gastritis

HP infection usually causes antral gastritis with increased acid secretion and risk of duodenal ulcer, or pangastritis with risk of ventricular ulcer and suppression of acid secretion. Eradication of the infection might therefore result in variable effects on acid related symptoms. Aim: To investigate the prevalence of new GERD symptoms (heartburn and regurgitation) in gastric and duodenal ulcer patients after HP eradication and consider its association with initial antral and corpus gastritis. Methods: 429 successfully eradicates HP-positive ulcers patients (GU 189 ; F/M 90/99, age 58, 7ys ; DU 240 ; F/M 103/137, age 51, 0ys.), were followed prospectively. After achieving eradication, all patients underwent endoscopy for at least 1-year intervals (range, 1-8 years). HP status was checked by endoscopy with histology (2 from antrum and 2 from corpus), and GERD status by questionnaire. The presence of gastritis was classified according to the updated Sydney classification, modified for the purpose of this study: Gastritis score(GS): activity (1-3) + chronic gastritis (1-3) + atrophy (1-3) for two specimens (corpus, antrum). Results: 47(25%)/189 GU patients and 72(30%)/240 DU patients worsened their GERD symptoms after HP eradication. Among this patients initial corpusGS was significantly higher then in patients without new GERD symptoms (GU 4, 45 versus 3, 52 ; DU 3, 78 versus 2, 78). AntrumGS didn't shows any significant difference (GU 5, 34 versus 5, 21 ; DU 5, 42 versus 5, 29). Conclusion: HP eradication in peptic ulcer patients with corpus gastritis, which is associated with an increase in gastric acid secretion, may be an important factor determining the higher prevalence of post HP eradication GERD.