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Abstract
Background: Helicobacter pylori causes chronic gastritis with variable
activity and topographic distribution. Patient age at acquisition,
expression of gastritis, strain virulence, host factors and environmental
factors determine the outcome of infection. Well-established
consequences are peptic ulcer disease (PUD) and gastric neoplasia.
However, the interrelation between H. pylori infection and GERD is
complex and poorly understood.
Patients and methods: The study was conducted on 30 patients
presenting to the Endoscopy Unit of Kasr-Elaini Hospital, Cairo
University, with upper gastro-intestinal symptoms (e.g. heartburn,
epigastric pain and regurgitation of acidic contents into the mouth) and in
whom upper endoscopy revealed signs of reflux esohagitis. Grading of
reflux oesophagitis was done according to the Los Angeles (LA)
classification system. Biopsies were obtained from the antrum, body,
cardia and the lower esophagus above the Z-line and were examined
histopathologically according to the Updated Sydney classification
system. Clinical, endoscopic and histopthological data were collected,
tabulated and statistically analyzed.
Results: Of the examined group, 12 patients (40%) proved to be H. pylori
positive and 18 patients (60%) proved to be H. pylori negative.
Prevalence of carditis increased with the H. pylori positive status more
than H. pylori negative (91.7% versus 72.2% respectively) as well as
severity of it (16.6% versus 5% respectively). Columnar-lined
oesophagus (CLO) was present in 2 patients (16.7%) of the H. pylori
positive group and 2 patients (11.1%) of the H. pylori negative group.
However, these results did not reach the statistical significance.
Conclusions: It was concluded that there is no statistically significant
correlation between H. pylori status and reflux esophagitis. The
prevalence and severity of carditis is more likely to be associated with H.
pylori other than reflux esophagitis. There is no correlation between H.
pylori status and the presence of Barrett’s esophagus.