Reflux Esophagitis Following Eradication of Helicobacter pylori-Positive Ulcer Disease

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.”

Reference

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