H-pylori and transient lower esophageal sphincter relaxations induced by gastric distension in healthy humans

The role of Helicobacter pylori infection in the control of lower esophagea l sphincter (LES) motility, especially the occurrence of transient LES rela xations (TLESRs), was studied in eight H. pylori-positive and eight H. pylo ri-negative healthy subjects. During endoscopy, biopsy specimens were taken from the cardia, fundus, and antrum for determinations of H. pylori status , gastritis, and proinflammatory cytokine mucosal concentrations. LES motil ity was monitored during three different 30-min periods: baseline, gastric distension (barostat), and gastric distension with CCK infusion. Gastric di stension significantly increased the TLESR rate, whereas CCK increased the rate of distension-induced TLESRs further and reduced resting LES pressure without significant differences between infected and noninfected subjects. H. pylori status did not influence resting LES pressure or gastric complian ce. Cytokine mucosal concentrations were increased in infected patients, bu t no correlation was found with the TLESR rate, which was also independent of inflammation at the cardia, fundus, and antrum. These results suggest th at H. pylori-associated inflammation does not affect the motor events invol ved in the pathogenesis of gastroesophageal reflux.