Reflux Esophagitis Following Eradication of Helicobacter pylori-Positive Ulcer Disease

H pylori
Investigators performed a cross-sectional study to assess reflux esophagitis in patients having undergone successful eradication of Helicobacter pylori infection.

The development of reflux esophagitis (RE) in patients experiencing Helicobacter pylori-positive ulcer disease can likely be attributed to successful eradication therapy and not previously undiagnosed RE, according to results of a study published in the European Journal of Internal Medicine.

A team of investigators from De Heel Zaans Medisch Centrum in Zaandam, the Netherlands, conducted a cross-sectional study involving patients experiencing active ulcer disease to evaluate coincidental RE. Patients were assessed for concomitant RE and hiatal hernia, and biopsy specimens were evaluated for the presence of H pylori.

The investigators discovered that active duodenal ulcer was the only irregularity in 375 (77%) patients. The researchers found that duodenal ulcer and concomitant RE were present in 43 (8.8%) patients, and duodenal ulcer with concomitant hiatal hernia were present in 69 (14.2%) patients. Patients with duodenal ulcer were much younger compared with patients with concomitant RE or hiatal hernia. The researchers found most patients in the duodenal ulcer group to be H pylori-positive. H pylori was more common in patients with active duodenal ulcer compared with patients with both duodenal ulcer and RE (P =.04).

The investigators also determined that gastric ulcer was the only irregularity in 218 (76%) patients; 15 (5.2%) patients had RE, and 54 (18.8%) had concomitant hiatal hernia. The researchers detected no difference in H pylori status among the 3 groups.

The study authors stated, “Given the low prevalence of concomitant RE, it is concluded that this condition is likely to occur in a large percentage of patients suffering from H pylori-positive ulcer disease after successful eradication therapy.”


Loffeld RJ, van der Putten AB. Reflux esophagitis and hiatal hernia as concomitant abnormality in patients presenting with active duodenal or gastric ulcer: cross-sectional endoscopic study in consecutive patients. Eur J Intern Med. 2002;13(2):199-202. doi:10.1016/s0953-6205(02)00021-3