REFLUX ESOPHAGITIS AND HELICOBACTER-PYLORI INFECTION IN ELDERLY PATIENTS

Helicobacter pylori is associated with gastritis, peptic ulcers and ga stric malignancies. Little attention has been paid to the possibility that it may also have a role in the pathogenesis of reflux oesophagiti s. This is especially true in elderly patients who have life-long infe ction and provide an ideal group to study the mucosal changes associat ed with the organism. The aim of this study was to determine if H pylo ri is associated with reflux oesophagitis in elderly patients. Consecu tive gastroscopy patients were recruited. Multiple biopsies were taken from oesophagus, stomach, antrum and duodenum for histology and rapid urease tests. Patients also had IgG ELISA antibodies and C-13-urea br eath tests performed. Patients with macroscopic or microscopic evidenc e of reflux oesophagitis were compared to patients with macroscopicall y normal upper gastrointestinal tracts and no microscopic evidence of reflux. A total of 114 patients were recruited, average age 78.9 years (+/- 5.4). There were 37 refluxers and 33 non-refluxers. We found no evidence for an association between the presence of H pylori and reflu x oesophagitis in elderly patients. The high prevalence of H pylori in patients with reflux oesophagitis can be explained by the presence of incidental gastritis.