H. pylori Infection is Negatively Associated with Reflux Esophagitis: A Cross-Sectional Case-Control Study of 5616 Health Check-up Koreans

Abstract

Background: The relationship between Helicobacter pylori infection and gastroesophageal reflux disease remains controversial. Aim: To investigate this relationship in a large Korean populationbased study. Methods: A cross-sectional case–control study of 5616 health check-up subjects undergoing upper gastrointestinal endoscopy was conducted (2808 cases with reflux esophagitis versus age- and sex-matched controls). Helicobacter pylori infection was determined by measuring anti-H. pylori IgG. Results: The prevalence of H. pylori infection was significantly lower in subjects with reflux esophagitis than in controls (38.4% vs 58.2%, p < .001). After adjusting for the effects of smoking, alcohol, waist circumference, and body mass index H. pylori infection is negatively associated with reflux esophagitis [odds ratio (OR) 0.44, 95% confidence interval (CI) 0.39–0.49]. There was significant inverse correlation between the severity of esphagitis and the prevalence of H. pylori infection. Subjects infected with H. pylori showed a significant increase in the risk of gastric atrophy (OR 3.22, 95% CI 2.79–3.70). Conclusions: H. pylori seropositivity was independently associated with the reduced risk for reflux esophagitis and correlates with the milder grade of esophagitis in Korean population, which suggest that H. pylori infection may play an inhibitory role for reflux esophagitis.