Helicobacter pylori and symptomatic relapse of gastro-oesophageal reflux diease: a randomised controlled trial

Background There is little information on the effects of Helicobacter pylor i eradication in patients with a primary diagnosis of gastro-oesophageal re flux disease (GORD). Our aim was to investigate the effect of H pylori erad ication in this group of patients. Methods We did-a double-blind, randomised, placebo-controlled study in 70 p atients with GORD. We assigned individuals to three groups. All patients re ceived lansoprazole 30 mg twice daily for 10 days, followed by 30 mg once d aily for 8 weeks. Patients infected with H pylori received either antibioti cs (clarithromycin 500 mg and amoxicillin 1000 mg twice daily) or placebo f or the first 10 days. Controls were patients not infected with H py(ori. Pa tients were followed up for 6 months at 2-week intervals for GORD symptoms. At the end of the study we repeated endoscopy and oesophageal and gastric 24 h-pH monitoring. Findings 58 of 70 patients completed our study. At the end of the study 16 of these patients were H pylori-positive (14 placebo and two eradication fa ilures), 13 were negative because of successful H pylori eradication, and 2 9 were controls. H pylori-positive patients relapsed earlier (54 days) than did those in whom H pylori was eradicated (100 days) (p=0.046). The H pylo ri-negative control group relapsed after the longest period (110 days). How ever, time to relapse: was also affected by oesophagitis grade (no oesophag itis 127 days, grade III or IV oesophagitis 18 days). When,results were cor rected for the affect of oesophagitis grade, H pylori positive patients rel apsed earlier (p=0.086) than H pylori-eradiated patients and controls (p=0. 001). Interpretation H pylori infection positively affects the relapse rate of GO RD. Eradication of H pylori could, therefore, help to prolong disease-free interval in patients with GORD.