Skip to main content
Top
Published in: BMC Infectious Diseases 1/2022

Open Access 01-12-2022 | Gastroesophageal Reflux Disease | Research

The association between helicobacter pylori infection and erosive gastroesophageal reflux disease; a cross-sectional study

Authors: Ramin Niknam, Kamran Bagheri Lankarani, Mohsen Moghadami, Seyed Alireza Taghavi, Leila Zahiri, Mohammad Javad Fallahi

Published in: BMC Infectious Diseases | Issue 1/2022

Login to get access

Abstract

Background

The association between H. pylori (Helicobacter pylori) infection and gastroesophageal reflux disease (GERD) is a complex and confusing subject. The aim of this study was to evaluate the association between helicobacter pylori infection and erosive gastroesophageal reflux disease.

Method

In a cross-sectional study, all patients referred for endoscopy due to dyspepsia were enrolled. The diagnosis of erosive GERD was made by endoscopy. Patients with normal esophagus were selected as comparison group. Random gastric biopsies were taken from all participants to diagnose H. pylori infection.

Result

In total, 1916 patients were included in this study, of whom 45.6% had GERD. The mean age (SD) was 42.95 (16.32). Overall, 1442 (75.3%) patients were positive for H. pylori infection. The frequency of H. pylori infection in mild GERD patients was higher than the severe GERD, but this difference was not significant (P = 0.214). Except for sociodemographic status (P < 0.001), other variables including gender, age, ethnicity, body mass index (BMI), smoking, and presence of hiatus hernia in patients had no significant association with the frequency of H. pylori infection. According to Robust Poisson regression models analysis, the association of H. pylori (PR 1.026; 95% CI 0.990–1.064; P = 0.158) and sociodemographic status were not significantly different between the two groups. But smoking, increased BMI, older age, presence of hiatus hernia, and peptic ulcer diseases were significantly associated with GERD compared with the non-GERD group.

Conclusion

In our results, there was no association between H. pylori infection and erosive GERD. Further studies are recommended.
Literature
1.
go back to reference Chen J, Brady P. Gastroesophageal reflux disease: pathophysiology, diagnosis, and treatment. Gastroenterol Nurs. 2019;42(1):20–8.PubMedCrossRef Chen J, Brady P. Gastroesophageal reflux disease: pathophysiology, diagnosis, and treatment. Gastroenterol Nurs. 2019;42(1):20–8.PubMedCrossRef
2.
4.
go back to reference Jonaitis L, Pellicano R, Kupcinskas L. Helicobacter pylori and nonmalignant upper gastrointestinal diseases. Helicobacter. 2018;23(Suppl 1):e12522.PubMedCrossRef Jonaitis L, Pellicano R, Kupcinskas L. Helicobacter pylori and nonmalignant upper gastrointestinal diseases. Helicobacter. 2018;23(Suppl 1):e12522.PubMedCrossRef
5.
go back to reference Yalaki S, Pulat H, Ilhan A. Localization of Helicobacter pylori gastritis and the relation of existing histopathological features with reflux esophagitis. Scand J Gastroenterol. 2020;55(1):27–33.PubMedCrossRef Yalaki S, Pulat H, Ilhan A. Localization of Helicobacter pylori gastritis and the relation of existing histopathological features with reflux esophagitis. Scand J Gastroenterol. 2020;55(1):27–33.PubMedCrossRef
6.
go back to reference Yucel O. Interactions between Helicobacter pylori and gastroesophageal reflux disease. Esophagus. 2019;16(1):52–62.PubMedCrossRef Yucel O. Interactions between Helicobacter pylori and gastroesophageal reflux disease. Esophagus. 2019;16(1):52–62.PubMedCrossRef
7.
go back to reference Ranjbar R, Behzadi P, Farshad S. Advances in diagnosis and treatment of Helicobacter pylori infection. Acta Microbiol Immunol Hung. 2017;64(3):273–92.PubMedCrossRef Ranjbar R, Behzadi P, Farshad S. Advances in diagnosis and treatment of Helicobacter pylori infection. Acta Microbiol Immunol Hung. 2017;64(3):273–92.PubMedCrossRef
8.
go back to reference Scida S, Russo M, Miraglia C, Leandro G, Franzoni L, Meschi T, et al. Relationship between Helicobacter pylori infection and GERD. Acta Biomed. 2018;89(8-S):40–3.PubMed Scida S, Russo M, Miraglia C, Leandro G, Franzoni L, Meschi T, et al. Relationship between Helicobacter pylori infection and GERD. Acta Biomed. 2018;89(8-S):40–3.PubMed
9.
go back to reference Niknam R, Manafi A, Fattahi MR, Mahmoudi L. The association between gastric endoscopic findings and histologic premalignant lesions in the Iranian rural population. Medicine (Baltimore). 2015;94(17):e715.PubMedCrossRef Niknam R, Manafi A, Fattahi MR, Mahmoudi L. The association between gastric endoscopic findings and histologic premalignant lesions in the Iranian rural population. Medicine (Baltimore). 2015;94(17):e715.PubMedCrossRef
10.
11.
go back to reference Armstrong D, Bennett JR, Blum AL, Dent J, De Dombal FT, Galmiche JP, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111(1):85–92.PubMedCrossRef Armstrong D, Bennett JR, Blum AL, Dent J, De Dombal FT, Galmiche JP, et al. The endoscopic assessment of esophagitis: a progress report on observer agreement. Gastroenterology. 1996;111(1):85–92.PubMedCrossRef
12.
go back to reference Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45(2):172–80.PubMedPubMedCentralCrossRef Lundell LR, Dent J, Bennett JR, Blum AL, Armstrong D, Galmiche JP, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut. 1999;45(2):172–80.PubMedPubMedCentralCrossRef
13.
go back to reference Tanaka Y, Sakata Y, Hara M, Kawakubo H, Tsuruoka N, Yamamoto K, et al. Risk factors for Helicobacter pylori infection and endoscopic reflux esophagitis in healthy young Japanese volunteers. Intern Med. 2017;56(22):2979–83.PubMedPubMedCentralCrossRef Tanaka Y, Sakata Y, Hara M, Kawakubo H, Tsuruoka N, Yamamoto K, et al. Risk factors for Helicobacter pylori infection and endoscopic reflux esophagitis in healthy young Japanese volunteers. Intern Med. 2017;56(22):2979–83.PubMedPubMedCentralCrossRef
14.
go back to reference Calleja JL, Suarez M, De Tejada AH, Navarro A, Pantogerd G. Helicobacter pylori infection in patients with erosive esophagitis is associated with rapid heartburn relief and lack of relapse after treatment with pantoprazole. Dig Dis Sci. 2005;50(3):432–9.PubMedCrossRef Calleja JL, Suarez M, De Tejada AH, Navarro A, Pantogerd G. Helicobacter pylori infection in patients with erosive esophagitis is associated with rapid heartburn relief and lack of relapse after treatment with pantoprazole. Dig Dis Sci. 2005;50(3):432–9.PubMedCrossRef
15.
go back to reference Hackelsberger A, Schultze V, Gunther T, von Arnim U, Manes G, Malfertheiner P. The prevalence of Helicobacter pylori gastritis in patients with reflux oesophagitis: a case-control study. Eur J Gastroenterol Hepatol. 1998;10(6):465–8.PubMedCrossRef Hackelsberger A, Schultze V, Gunther T, von Arnim U, Manes G, Malfertheiner P. The prevalence of Helicobacter pylori gastritis in patients with reflux oesophagitis: a case-control study. Eur J Gastroenterol Hepatol. 1998;10(6):465–8.PubMedCrossRef
16.
go back to reference Fattahi MR, Niknam R, Shams M, Anushiravani A, Taghavi SA, Omrani GR, et al. The association between prolonged proton pump inhibitors use and bone mineral density. Risk Manag Healthc Policy. 2019;12:349–55.PubMedPubMedCentralCrossRef Fattahi MR, Niknam R, Shams M, Anushiravani A, Taghavi SA, Omrani GR, et al. The association between prolonged proton pump inhibitors use and bone mineral density. Risk Manag Healthc Policy. 2019;12:349–55.PubMedPubMedCentralCrossRef
17.
go back to reference Wang PC, Hsu CS, Tseng TC, Hsieh TC, Chen CH, Su WC, et al. Male sex, hiatus hernia, and Helicobacter pylori infection associated with asymptomatic erosive esophagitis. J Gastroenterol Hepatol. 2012;27(3):586–91.PubMedCrossRef Wang PC, Hsu CS, Tseng TC, Hsieh TC, Chen CH, Su WC, et al. Male sex, hiatus hernia, and Helicobacter pylori infection associated with asymptomatic erosive esophagitis. J Gastroenterol Hepatol. 2012;27(3):586–91.PubMedCrossRef
18.
go back to reference Ko SH, Baeg MK, Jung HS, Kim P, Choi MG. Russian Caucasians have a higher risk of erosive reflux disease compared with East Asians: a direct endoscopic comparison. Neurogastroenterol Motil. 2017;29(5):e13002.CrossRef Ko SH, Baeg MK, Jung HS, Kim P, Choi MG. Russian Caucasians have a higher risk of erosive reflux disease compared with East Asians: a direct endoscopic comparison. Neurogastroenterol Motil. 2017;29(5):e13002.CrossRef
19.
go back to reference Nam SY, Park BJ, Cho YA, Ryu KH, Choi IJ, Park S, et al. Different effects of dietary factors on reflux esophagitis and non-erosive reflux disease in 11,690 Korean subjects. J Gastroenterol. 2017;52(7):818–29.PubMedCrossRef Nam SY, Park BJ, Cho YA, Ryu KH, Choi IJ, Park S, et al. Different effects of dietary factors on reflux esophagitis and non-erosive reflux disease in 11,690 Korean subjects. J Gastroenterol. 2017;52(7):818–29.PubMedCrossRef
20.
go back to reference Mari A, Mahroum N, Bragazzi NL, Shalaata M, Khoury T, Watad A, et al. Demographics and clinical and endoscopic characteristics of patients with Helicobacter pylori infection and gastroesophageal reflux disease: a case-control study. Gastroenterol Res Pract. 2019;2019:3819893.PubMedPubMedCentralCrossRef Mari A, Mahroum N, Bragazzi NL, Shalaata M, Khoury T, Watad A, et al. Demographics and clinical and endoscopic characteristics of patients with Helicobacter pylori infection and gastroesophageal reflux disease: a case-control study. Gastroenterol Res Pract. 2019;2019:3819893.PubMedPubMedCentralCrossRef
22.
go back to reference Nobakht H, Boghratian A, Sohrabi M, Panahian M, Rakhshani N, Nikkhah M, et al. Association between pattern of gastritis and gastroesophageal reflux disease in patients with Helicobacter pylori infection. Middle East J Dig Dis. 2016;8(3):206–11.PubMedPubMedCentralCrossRef Nobakht H, Boghratian A, Sohrabi M, Panahian M, Rakhshani N, Nikkhah M, et al. Association between pattern of gastritis and gastroesophageal reflux disease in patients with Helicobacter pylori infection. Middle East J Dig Dis. 2016;8(3):206–11.PubMedPubMedCentralCrossRef
23.
go back to reference Shavalipour A, Malekpour H, Dabiri H, Kazemian H, Zojaji H, Bahroudi M. Prevalence of cytotoxin-associated genes of Helicobacter pylori among Iranian GERD patients. Gastroenterol Hepatol Bed Bench. 2017;10(3):178–83.PubMedPubMedCentral Shavalipour A, Malekpour H, Dabiri H, Kazemian H, Zojaji H, Bahroudi M. Prevalence of cytotoxin-associated genes of Helicobacter pylori among Iranian GERD patients. Gastroenterol Hepatol Bed Bench. 2017;10(3):178–83.PubMedPubMedCentral
24.
go back to reference Grande M, Lisi G, De Sanctis F, Grande S, Esser A, Campanelli M, et al. Does a relationship still exist between gastroesophageal reflux and Helicobacter pylori in patients with reflux symptoms? World J Surg Oncol. 2014;12:375.PubMedPubMedCentralCrossRef Grande M, Lisi G, De Sanctis F, Grande S, Esser A, Campanelli M, et al. Does a relationship still exist between gastroesophageal reflux and Helicobacter pylori in patients with reflux symptoms? World J Surg Oncol. 2014;12:375.PubMedPubMedCentralCrossRef
25.
go back to reference Gisbert JP, de Pedro A, Losa C, Barreiro A, Pajares JM. Helicobacter pylori and gastroesophageal reflux disease: lack of influence of infection on twenty-four-hour esophageal pH monitoring and endoscopic findings. J Clin Gastroenterol. 2001;32(3):210–4.PubMedCrossRef Gisbert JP, de Pedro A, Losa C, Barreiro A, Pajares JM. Helicobacter pylori and gastroesophageal reflux disease: lack of influence of infection on twenty-four-hour esophageal pH monitoring and endoscopic findings. J Clin Gastroenterol. 2001;32(3):210–4.PubMedCrossRef
26.
go back to reference Oberg S, Peters JH, Nigro JJ, Theisen J, Hagen JA, DeMeester SR, et al. Helicobacter pylori is not associated with the manifestations of gastroesophageal reflux disease. Arch Surg. 1999;134(7):722–6.PubMedCrossRef Oberg S, Peters JH, Nigro JJ, Theisen J, Hagen JA, DeMeester SR, et al. Helicobacter pylori is not associated with the manifestations of gastroesophageal reflux disease. Arch Surg. 1999;134(7):722–6.PubMedCrossRef
27.
go back to reference Grande M, Cadeddu F, Villa M, Attina GM, Muzi MG, Nigro C, et al. Helicobacter pylori and gastroesophageal reflux disease. World J Surg Oncol. 2008;6:74.PubMedPubMedCentralCrossRef Grande M, Cadeddu F, Villa M, Attina GM, Muzi MG, Nigro C, et al. Helicobacter pylori and gastroesophageal reflux disease. World J Surg Oncol. 2008;6:74.PubMedPubMedCentralCrossRef
28.
go back to reference O’Connor HJ, Cunnane K. Helicobacter pylori and gastro-oesophageal reflux disease—a prospective study. Ir J Med Sci. 1994;163(8):369–73.PubMedCrossRef O’Connor HJ, Cunnane K. Helicobacter pylori and gastro-oesophageal reflux disease—a prospective study. Ir J Med Sci. 1994;163(8):369–73.PubMedCrossRef
29.
go back to reference Pieramico O, Zanetti MV. Relationship between intestinal metaplasia of the gastro-oesophageal junction, Helicobacter pylori infection and gastro-oesophageal reflux disease: a prospective study. Dig Liver Dis. 2000;32(7):567–72.PubMedCrossRef Pieramico O, Zanetti MV. Relationship between intestinal metaplasia of the gastro-oesophageal junction, Helicobacter pylori infection and gastro-oesophageal reflux disease: a prospective study. Dig Liver Dis. 2000;32(7):567–72.PubMedCrossRef
30.
go back to reference Miftahussurur M, Doohan D, Nusi IA, Adi P, Rezkitha YAA, Waskito LA, et al. Gastroesophageal reflux disease in an area with low Helicobacter pylori infection prevalence. PLoS ONE. 2018;13(11):e0205644.PubMedPubMedCentralCrossRef Miftahussurur M, Doohan D, Nusi IA, Adi P, Rezkitha YAA, Waskito LA, et al. Gastroesophageal reflux disease in an area with low Helicobacter pylori infection prevalence. PLoS ONE. 2018;13(11):e0205644.PubMedPubMedCentralCrossRef
31.
go back to reference Jie W, Qinghong X, Zhitao C. Association of Helicobacter pylori infection with gastroesophageal reflux disease. J Int Med Res. 2019;47(2):748–53.PubMedCrossRef Jie W, Qinghong X, Zhitao C. Association of Helicobacter pylori infection with gastroesophageal reflux disease. J Int Med Res. 2019;47(2):748–53.PubMedCrossRef
32.
go back to reference Fallone CA, Barkun AN, Friedman G, Mayrand S, Loo V, Beech R, et al. Is Helicobacter pylori eradication associated with gastroesophageal reflux disease? Am J Gastroenterol. 2000;95(4):914–20.PubMedCrossRef Fallone CA, Barkun AN, Friedman G, Mayrand S, Loo V, Beech R, et al. Is Helicobacter pylori eradication associated with gastroesophageal reflux disease? Am J Gastroenterol. 2000;95(4):914–20.PubMedCrossRef
33.
go back to reference McColl KE, Dickson A, El-Nujumi A, El-Omar E, Kelman A. Symptomatic benefit 1–3 years after H. pylori eradication in ulcer patients: impact of gastroesophageal reflux disease. Am J Gastroenterol. 2000;95(1):101–5.PubMed McColl KE, Dickson A, El-Nujumi A, El-Omar E, Kelman A. Symptomatic benefit 1–3 years after H. pylori eradication in ulcer patients: impact of gastroesophageal reflux disease. Am J Gastroenterol. 2000;95(1):101–5.PubMed
34.
go back to reference Rokkas T, Ladas SD, Triantafyllou K, Liatsos C, Petridou E, Papatheodorou G, et al. The association between CagA status and the development of esophagitis after the eradication of Helicobacter pylori. Am J Med. 2001;110(9):703–7.PubMedCrossRef Rokkas T, Ladas SD, Triantafyllou K, Liatsos C, Petridou E, Papatheodorou G, et al. The association between CagA status and the development of esophagitis after the eradication of Helicobacter pylori. Am J Med. 2001;110(9):703–7.PubMedCrossRef
35.
go back to reference Schwizer W, Thumshirn M, Dent J, Guldenschuh I, Menne D, Cathomas G, et al. Helicobacter pylori and symptomatic relapse of gastro-oesophageal reflux disease: a randomised controlled trial. Lancet. 2001;357(9270):1738–42.PubMedCrossRef Schwizer W, Thumshirn M, Dent J, Guldenschuh I, Menne D, Cathomas G, et al. Helicobacter pylori and symptomatic relapse of gastro-oesophageal reflux disease: a randomised controlled trial. Lancet. 2001;357(9270):1738–42.PubMedCrossRef
36.
go back to reference Take S, Mizuno M, Ishiki K, Nagahara Y, Yoshida T, Yokota K, et al. Helicobacter pylori eradication may induce de novo, but transient and mild, reflux esophagitis: prospective endoscopic evaluation. J Gastroenterol Hepatol. 2009;24(1):107–13.PubMedCrossRef Take S, Mizuno M, Ishiki K, Nagahara Y, Yoshida T, Yokota K, et al. Helicobacter pylori eradication may induce de novo, but transient and mild, reflux esophagitis: prospective endoscopic evaluation. J Gastroenterol Hepatol. 2009;24(1):107–13.PubMedCrossRef
37.
go back to reference Xie T, Cui X, Zheng H, Chen D, He L, Jiang B. Meta-analysis: eradication of Helicobacter pylori infection is associated with the development of endoscopic gastroesophageal reflux disease. Eur J Gastroenterol Hepatol. 2013;25(10):1195–205.PubMed Xie T, Cui X, Zheng H, Chen D, He L, Jiang B. Meta-analysis: eradication of Helicobacter pylori infection is associated with the development of endoscopic gastroesophageal reflux disease. Eur J Gastroenterol Hepatol. 2013;25(10):1195–205.PubMed
38.
go back to reference Mahmoudi L, Farshad S, Seddigh M, Mahmoudi P, Ejtehadi F, Niknam R. High efficacy of gemifloxacin-containing therapy in Helicobacter pylori eradication: a pilot empirical second-line rescue therapy. Medicine (Baltimore). 2016;95(42):e4410.PubMedCrossRef Mahmoudi L, Farshad S, Seddigh M, Mahmoudi P, Ejtehadi F, Niknam R. High efficacy of gemifloxacin-containing therapy in Helicobacter pylori eradication: a pilot empirical second-line rescue therapy. Medicine (Baltimore). 2016;95(42):e4410.PubMedCrossRef
39.
go back to reference Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017;66(1):6–30.PubMedCrossRef Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report. Gut. 2017;66(1):6–30.PubMedCrossRef
40.
go back to reference Spechler SJ. Does Helicobacter pylori infection contribute to gastroesophageal reflux disease? Yale J Biol Med. 1998;71(2):143–8.PubMedPubMedCentral Spechler SJ. Does Helicobacter pylori infection contribute to gastroesophageal reflux disease? Yale J Biol Med. 1998;71(2):143–8.PubMedPubMedCentral
41.
go back to reference Thor PJ, Blaut U. Helicobacter pylori infection in pathogenesis of gastroesophageal reflux disease. J Physiol Pharmacol. 2006;57(Suppl 3):81–90.PubMed Thor PJ, Blaut U. Helicobacter pylori infection in pathogenesis of gastroesophageal reflux disease. J Physiol Pharmacol. 2006;57(Suppl 3):81–90.PubMed
Metadata
Title
The association between helicobacter pylori infection and erosive gastroesophageal reflux disease; a cross-sectional study
Authors
Ramin Niknam
Kamran Bagheri Lankarani
Mohsen Moghadami
Seyed Alireza Taghavi
Leila Zahiri
Mohammad Javad Fallahi
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2022
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-022-07278-6

Other articles of this Issue 1/2022

BMC Infectious Diseases 1/2022 Go to the issue