Helicobacter pylori and Gastroesophageal Reflux Disease. In Practical Manual of Gastroesophageal Reflux Disease.

Helicobacter pylori is one of the most common chronic infections of mankind and etiologically related to gastritis, peptic ulcer, and gastric cancer (i.e. whenever H. pylori is diagnosed, it should be eradicated). Gastroesophageal reflux disease and H. pylori frequently co-exist and questions frequently arise concerning whether eradication of H. pylori has an influence on gastroesophageal reflux disease and its sequelae such as Barrett's esophagus or esophageal adenocarcinoma. The brief answer is, no. H. pylori eradication neither causes gastroesophageal reflux disease nor significantly influences gastroesophageal reflux disease therapy. H. pylori does not protect against Barrett's or adenocarcinoma of the esophagus. Chronic atrophic gastritis, the high-risk precursor lesion for gastric cancer, reduces acid secretion and thus symptomatic gastroesophageal reflux disease and its sequelae. In contrast, anti-secretory drug therapy for gastroesophageal reflux disease likely increases the rate of development of corpus gastritis and may increase the risk of gastric cancer. H. pylori eradication is recommended for all with co-existing gastroesophageal reflux disease.