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H. pylori infection less common among patients with Barrett's esophagus, erosive esophagitis
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ORLANDO, Fla. – Barrett’s esophagus and erosive esophagitis are inversely associated with Helicobacter pylori infection, according to data presented here at Digestive Disease Week.
In a cross-sectional study, researchers measured antibodies against H. pylori and cytotoxin-associated gene A (cagA) in serum collected from 150 patients with Barrett’s esophagus (BE), 155 participants with symptoms of GERD and 225 patients with erosive esophagitis (EE). All patients were male and aged between 50 and 79 years.
“In our cross-sectional cohort, we confirmed that H. pylori was inversely associated with erosive esophagitis and Barrett’s esophagus, but found no association with GERD symptoms, raising the question then of how H. pylori might decrease the risk of Barrett’s,” researcher Joel H. Rubenstein, MD, MSc, assistant professor in the gastroenterology division at the University of Michigan Medical School, told Healio.com. “The short answer is that we do not know yet, but it might involve anti-inflammatory effects of H. pylori DNA; differences in inflammatory responses among patients that both predispose to H. pylori infection and protect against esophagitis; or changes in esophageal microbiota aside from H. pylori.”
H. pylori infection was present in 73 patients studied, including 36 who also tested positive for cagA. Patients with H. pylori infection were significantly less likely to have BE after adjustment for factors including age, waist-to-hip ratio, race, education and tobacco use (adjusted OR=0.532, 0.291-0.974). This association was more pronounced among cagA-positive participants with H. pylori (aOR=0.356, 0.14-0.902). A similar association was observed between H. pylori infection and EE, both overall (aOR=0.63, 0.366-1.08) and among cagA-positive patients (aOR=0.468, 0.213-1.03). However, no significant associations were observed between H. pylori infection and the presence of weekly or more frequent GERD symptoms (aOR=0.948, 0.548-1.64).
Investigators also noted that patients with either BE (aOR=0.289, 95% CI, 0.112-0.742) or EE (aOR=0.411, 95% CI, 0.175-0.968) were significantly less likely to have H. pylori infection than those with NERD (patients with weekly or more frequent GERD symptoms without BE or EE, who were not taking proton-pump inhibitors or histamine-2 receptor antagonists).
Disclosures: The researchers report numerous financial disclosures.
Rubenstein JH. #17: Associations of Helicobacter pylori with symptoms of GERD, Erosive Esophagitis and Barrett’s Esophagus. Presented at: Digestive Disease Week; May 18-21, Orlando, Fla.