REFLUX AND HELICOBACTER-PYLORI

Helicobacter pylori is not a risk factor for gastrooesophageal reflux and oesophagitis, and there are arguments suggesting that H. pylori ma y actually protect against gastro-oesophageal reflux disease. Gastrooe sophageal reflux disease patients are less often infected with H. pylo ri than controls. If infected, they may have less severe gastro-oesoph ageal reflux disease, and H. pylori infected duodena[ ulcer patients w ithout gastro-oesophageal reflux disease are potentially at risk of de veloping gastrooesophageal reflux disease after eradication of the org anism, In addition, H. pylori also affects the management of gastro-oe sophageal reflux disease. H. pylori eradication may decrease the acid- lowering capacity of proton pump inhibitors and H2 receptor antagonist s, and it could induce or aggravate gastro-oesophageal reflux. Proton pump inhibitor treatment of gastro-oesophageal reflux disease may be a ssociated with an accelerated development of atrophic gastritis in H. pylori positive patients, suggesting that H. pylori should be diagnose d and eradicated in these patients, The role of H. pylori in duodenoga stric reflux remains controversial.