Randomised controlled trial of effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux: Bristol helicobacter project

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Abstract

Objectives

To investigate the effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux.

Design

Cross sectional study, followed by a randomised placebo controlled trial.

Setting

Seven general practices in Bristol, England.

Setting

Participants 10 537 people, aged 20-59 years, with and without H pylori infection (determined by the 13C-urea breath test).

Main outcome measures

Prevalence of heartburn and gastro-oesophageal acid reflux at baseline and two years after treatment to eradicate H pylori infection.

Results

At baseline, H pylori infection was associated with increased prevalence of heartburn (odds ratio 1.14, 95% confidence interval 1.05 to 1.23) but not reflux (1.05, 0.97 to 1.14). In participants with H pylori infection, active treatment had no effect on the overall prevalence of heartburn (0.99, 0.88 to 1.12) or reflux (1.04, 0.91 to 1.19) and did not improve pre-existing symptoms of heartburn or reflux.

Conclusions

H pylori infection is associated with a slightly increased prevalence of heartburn but not reflux. Treatment to eradicate H pylori has no net benefit in patients with heartburn or gastro-oesophageal reflux.

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