Helicobacter pylori infection, pattern of gastritis, and symptoms in erosive and nonerosive gastroesophageal reflux disease

Background: The aim of this study was to evaluate the prevalence of Helicob acter pylori infection and the characteristics of gastritis and symptoms of patients with erosive and nonerosive gastroesophageal reflux disease (GERD ). Methods: We studied 202 consecutive patients with a diagnosis of GERD (s ymptoms score and endoscopy): group A (n = 110, erosive GERD; group B (n = 92), nonerosive GERD; 200 patients with upper abdominal complaints without abnormalities at endoscopy (functional dyspepsia, group C); and 200 asympto matic controls tested for H. pylori serum antibody (group D). Antral and bo dy biopsy specimens were taken for histology and the rapid urease test in g roups A, B, and C. Results: The prevalence of H. pylori infection was highe r in groups B and C (62% and 55%, respectively) than in A and D (36% and 40 %) (P < 0.05). In positive patients H, pylori colonization and gastritis gr ade scores in the gastric body were higher in nonerosive than in erosive GE RD and functional dyspepsia (P < 0.05). No differences in H.pylori coloniza tion or gastritis grades were found in the antrum. Fifty-nine patients with nonerosive GERD (64%) and 42 with erosive GERD (38%) showed other dyspepti c symptoms associated with reflux symptoms (P < 0.05). Conclusions: H. pylo ri prevalence is higher in patients with nonerosive GERD than in normal sub jects and in patients with erosive GERD and similar to that of patients wit h dyspepsia. Patients with nonerosive GERD often show dyspeptic symptoms an d higher H. pylori colonization and inflammation grades in the proximal sto mach. Our data support the hypothesis that in GERD H. pylori gastritis may, on the one hand, protect against the development of esophageal erosions an d, on the other, contribute to the esophageal hypersensitivity to acid whic h is a feature of GERD.