Premium
Dysfunction of oesophageal motility in Helicobacter pylori ‐infected patients with reflux oesophagitis
Author(s) -
Wu J. C. Y.,
Lai A. C. W.,
Wong S. K. H.,
Chan F. K. L.,
Leung W.K.,
Sung J. J. Y.
Publication year - 2001
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2001.01132.x
Subject(s) - gastroenterology , medicine , reflux , helicobacter pylori , rapid urease test , peristalsis , gastro , esophageal disease , spirillaceae , esophagus , disease , gastritis
Background: Helicobacter pylori infection has been suggested to be protective against gastro‐oesophageal reflux disease. However, a significant proportion of patients with gastro‐oesophageal reflux disease are infected by H. pylori . Aim: To study oesophageal motor function in H. pylori ‐infected patients with reflux oesophagitis. Methods: Patients with erosive reflux oesophagitis were recruited prospectively for stationary oesophageal manometry and 24‐h ambulatory oesophageal pH monitoring. H. pylori status was determined by biopsy urease test. Non‐reflux volunteers were recruited as controls. Results: Seventy‐four patients with erosive oesophagitis (34 H. pylori ‐positive, 40 H. pylori ‐negative) and 48 non‐reflux patient controls (22 H. pylori ‐positive, 26 H. pylori ‐negative) were recruited. There was no difference in severity of oesophagitis (median grade, 1; P =0.53) or oesophageal acid exposure (total percentage time oesophageal pH < 4, 7.6% vs. 6.8%; P =0.57) between H. pylori ‐positive and H. pylori ‐negative groups. Compared to H. pylori ‐negative patients, H. pylori ‐positive patients had significantly lower basal lower oesophageal sphincter pressure (12.2 mmHg vs. 15.3 mmHg; P =0.03) and amplitude of distal peristalsis (56.9 mmHg vs. 68.4 mmHg; P =0.03). Ineffective oesophageal motility (14% vs. 7%; P =0.02) and failed oesophageal peristalsis were also significantly more prevalent in H. pylori ‐positive patients. Conclusions: Among patients with a similar degree of reflux oesophagitis, H. pylori ‐infected patients have more severe oesophageal dysmotility and lower oesophageal sphincter dysfunction. Oesophageal motor dysfunction probably plays a dominant role in the development of gastro‐oesophageal reflux disease in patients with H. pylori infection.