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Helicobacter pylori, Ethnicity, and the Gastroesophageal Reflux Disease Spectrum: A Study from the East

Citation

Rajendra, S and Ackroyd, R and Robertson, IK and Ho, JJ and Karim, N and Kutty, KM, Helicobacter pylori, Ethnicity, and the Gastroesophageal Reflux Disease Spectrum: A Study from the East, Helicobacter, 12, (2) pp. 177-183. ISSN 1083-4389 (2007) [Refereed Article]

DOI: doi:10.1111/j.1523-5378.2007.00489.x

Abstract

Background: Ethnic differences in gastroesophageal reflux disease (GERD) and its complications as well as racial variations in the prevalence of Helicobacter pylori infection are well documented. Nevertheless, the association between reflux disease, H. pylori, and race has not been adequately explored. Aims: We estimated the strength of the association between H. pylori, ethnicity, and the gastroesophageal reflux disease (GERD) spectrum, including Barrett's esophagus, in Asian patients presenting for endoscopy in a tertiary referral center. Methods: Prospectively, we studied 188 consecutive patients with GERD, short- and long-segment Barrett's esophagus, and controls. All patients underwent gastroscopy with gastric biopsies to assess H. pylori, gastritis, and atrophy. CagA status and H. pylori infection were determined by immunoblot assay. Results: The overall prevalence of H. pylori infection was 52.1% (of which 77.6% were cagA+) and was lowest in the long-segment Barrett's esophagus group (36.7%) (p =.048). When Barrett's esophagus was present, the length of abnormality was 44.8% shorter in the presence of H. pylori (p =.015). Indians had the highest prevalence of H. pylori (75%) and Malays the lowest (19.6%) (p <.001). In Indians, increased prevalence of H. pylori and cagA-positive strains was associated with reduced severity of GERD (p <.004 and p <.001, respectively), a trend not apparent in the other races. Corpus atrophy, which was almost exclusively associated with H. pylori, was highest in Indians as compared to the other races (p =.013). Conclusions: Presence of H. pylori was associated with a reduced severity of GERD spectrum disease in Asians, especially Indians. H. pylori infection may protect against complicated reflux disease via induction of corpus atrophy. © 2007 The Authors.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Gastroenterology and Hepatology
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Digestive System Disorders
Author:Robertson, IK (Dr Iain Robertson)
ID Code:50015
Year Published:2007
Web of Science® Times Cited:33
Deposited By:Health Sciences A
Deposited On:2007-08-01
Last Modified:2010-04-13
Downloads:0

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