Effectiveness of acid suppression in preventing gastroesophageal reflux disease (GERD) after successful treatment of Helicobacter pylori infection

There is evidence that Helicobacter pylori eradication might predispose to gastroesophageal reflux disease (GERD). The aim of this prospective study w as to examine the effectiveness of antisecretory treatment, after successfu l H. pylori eradication, in preventing GERD, since no data exist so far. Ei ghty initially H. pylori(+) patients, without GERD at the time of H. pylori eradication [50 peptic ulcer (PU) and 30 nonulcer (NU), 55 men, 25 women, median age 38 years, range 19-57], after successful H. pylori eradication w ere randomized to recieve either omeprazole 20 mg daily (group A) or no tre atment (group B) for one year. All patients underwent upper gastrointestina l endoscopy at 0, 6, and 12 months or when GERD symptoms occurred. There we re 40 patients in each group, and there were no statistically significant d ifferences between the two groups in terms of sex, age, body weight, ulcer/ no ulcer ratio, and other demographic data. Seven patients from group A and five patients from group B were lost to follow-up, and therefore there wer e 33 and 35 patients in groups A and B, respectively, who completed the stu dy. One of 33 patients in group A (3%) and 10/35 (28.5%) in group B develop ed GERD symptoms during follow-up (P = 0.0022). The respective values for e sophagitis were 0/33(0%) and 6/35(17.1%) (P = 0.0083). In conclusion, antis ecretory treatment in H. pylori(+) patients, after successful eradication, is effective in preventing GERD.