Correlazione tra infezione da Helicobacter pylori e malattia da reflusso gastroesofageo

The possible relationship betwen H.pylori infection and gastroesophageal reflux disease (GERD) has been recently claimed and is a matter of great debate. An increase in the incidence of oesophagitis after H. pylori eradication has been observed, but these data are only supported by endoscopy. The presence of non-erosive reflux disease (NERD) has been shown to be higher than oesophagitis and, therefore, further data based on pH-monitoring are needed. The aim of our study was to evaluate oesophageal acid exposure in patients with GERD, both H.pylori-positive and H.pylori-negative. We studied 76 consecutive patients (44 M, mean age 54.9±12.9 years) with typical and atypical symptoms of GERD. All patients underwent 24-hour oesophageal pH-metry and oesophagogastroduodenoscopy; they were grouped as H. pylori-positive and H.pylori-negative on the basis of both CLO-test and histology. We used the Los Angeles classification for grading oesophagitis and the Sydney score system for grading gastritis. Statistical analysis was performed by Mann-Whitney U test. A p value less than 0.05 was considered significant. We found 27 H.pylori-positive patients (mean age 56.9 ± 13.9) and 49 H.pylori-negative ones (mean age 53.9 ± 12.3). No differences were found between the two groups as far as the demographic and clinical characteristics are concerned. No statistical differences were observed in oesophageal mean pH value during the 24 hour period (4,7 vs 4,6, respectively) and the per cent value of time spent at pH <4 during the 24-hour period (28.5% vs 28.4%, respectively) between H.pylori-positive and H.pylori-negative patients with GERD. Moreover, similar results were found between H.pylori-positive and H.pylori-negative patients with NERD (mean pH value 5,2 vs 5,0; percent value of time spent at pH