Could Ulcer Treatment Improve Acid-Reflux Symptoms?
"Presence of H. pylori leads to a reduced disease-free interval, and, therefore, eradication therapy should be considered in patients with [GERD]," write Werner Schwizer, MD and colleagues.
In an interview with WebMD, Schwizer, associate professor of gastroenterology at University Hospital in Zurich, Switzerland, says that the theory about H. pylori being protective against GERD arose following an observation that some duodenal ulcer patients who received antibiotics to kill H. pylori infection later went on to develop Barrett's esophagitis, a disorder linked to acid-reflux disease. "There was indirect evidence, lets say observational evidence, without really testing that, so that was the basis of our study."
In the study 70 patients with GERD were divided into three groups, with all patients receiving the acid reducer Prevacid 30 mg twice daily for 10 days, followed by 30 mg once daily for 8 weeks. Patients who were infected with H. pylori were randomly assigned to receive either antibiotics or a placebo for the first 10 days. Patients not infected with H. pylori were used for comparison, which was called the control group.
The patients were followed for 6 months at 2-week intervals for GERD symptoms. At the end of the study, the researchers determined that patients who were still infected with H. pylori had on average an earlier return of symptoms (at 54 days) than patients in whom H. pylori had been eradicated (at 100 days). The control group had the longest symptom-free period, at 110 days.
When they classified the patients according to severity of inflammation of the esophagus, called esophagitis, those with the most inflammation relapsed rapidly, compared to those with low levels of inflammation. Once again, after the researchers considered the amount of esophagitis a patient had, the investigators found that those with H. pylori relapsed more rapidly.
The study was small, however -- only 58 patients completed the study, and the authors acknowledge that further research of the underlying mechanisms will be needed to confirm their observations.
A gastroenterologist who was not involved in the study tells WebMD that he's still not convinced.