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. PARTICIPANTS: 10,537 people,
aged 20-59 years, with and without
H pylori infection (determined by the (13)C-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.
