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Article

Endoscopic Reflux Esophagitis and Reflux-Related Symptoms after Helicobacter pylori Eradication Therapy: Meta-Analysis

1
Department of Gastroenterological Endoscopy, Tokyo Medical University Hospital, Shinjuku, Tokyo 160-0023, Japan
2
Department of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto 612-8555, Japan
3
Toyoda Aoba Clinic, Iwata, Shizuoka 438-0821, Japan
4
Department of Gastroenterology and Hepatology, Tokyo Medical University Hospital, Shinjuku, Tokyo 160-0023, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(9), 3007; https://doi.org/10.3390/jcm9093007
Received: 12 August 2020 / Revised: 14 September 2020 / Accepted: 15 September 2020 / Published: 18 September 2020
(This article belongs to the Special Issue Helicobacter Pylori Infection and Related Diseases)
Backgrounds: The etiology of gastroesophageal reflux disease (GERD) including reflux esophagitis and non-erosive reflux disease is multifactorial and a recent meta-analysis showed no association between the development of GERD and Helicobacter pylori eradication in both Western and East-Asian populations. However, the problem remains that various inclusion criteria are used in these studies, which hinders meta-analysis. With a focus on reflux esophagitis with endoscopic mucosal injury, we meta-analysed to evaluate the association between eradication and reflux esophagitis and symptoms using a clearly defined set of inclusion criteria. Methods: We conducted a meta-analysis of studies published up until March 2020, which compared the incidence of reflux esophagitis and symptoms between patients undergoing H. pylori eradication therapy in a randomized placebo-controlled trial (Category A); between patients with successful and failed eradication (Category B); and between patients with successful vs. failed eradication, receipt of placebo, or no-treatment H. pylori-positives (Category C). Results: A total of 27 studies were included. Significant statistical effects were found for development of endoscopic reflux esophagitis [relative risk (RR): 1.46, 95% confidence interval (CI): 1.16–1.84, p = 0.01] or de novo reflux esophagitis (RR: 1.42, 95% CI: 1.01–2.00, p = 0.03) in the case group that received eradication in all studies, especially in Western populations. There was no significant difference in the incidence of symptoms after eradication between patient and control groups, regardless of category, location of population, or baseline disease. Conclusions: Eradication therapy for H pylori increases the risk of reflux esophagitis, irrespective of past history of esophagitis. In contrast, no effect was seen on reflux-related symptoms. View Full-Text
Keywords: reflux esophagitis; Helicobacter pylori; eradication therapy; GERD; Western population reflux esophagitis; Helicobacter pylori; eradication therapy; GERD; Western population
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MDPI and ACS Style

Sugimoto, M.; Murata, M.; Mizuno, H.; Iwata, E.; Nagata, N.; Itoi, T.; Kawai, T. Endoscopic Reflux Esophagitis and Reflux-Related Symptoms after Helicobacter pylori Eradication Therapy: Meta-Analysis. J. Clin. Med. 2020, 9, 3007. https://doi.org/10.3390/jcm9093007

AMA Style

Sugimoto M, Murata M, Mizuno H, Iwata E, Nagata N, Itoi T, Kawai T. Endoscopic Reflux Esophagitis and Reflux-Related Symptoms after Helicobacter pylori Eradication Therapy: Meta-Analysis. Journal of Clinical Medicine. 2020; 9(9):3007. https://doi.org/10.3390/jcm9093007

Chicago/Turabian Style

Sugimoto, Mitsushige, Masaki Murata, Hitomi Mizuno, Eri Iwata, Naoyoshi Nagata, Takao Itoi, and Takashi Kawai. 2020. "Endoscopic Reflux Esophagitis and Reflux-Related Symptoms after Helicobacter pylori Eradication Therapy: Meta-Analysis" Journal of Clinical Medicine 9, no. 9: 3007. https://doi.org/10.3390/jcm9093007

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