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The effect of Helicobacter pylori eradication to acid reflux in patients with duodenal ulcer disease

Yıl 2008, Cilt: 7 Sayı: 1, 34 - 38, 01.04.2008

Öz

Background: The effect of Helicobacter pylori in provoking or protecting gastro-oesophageal reflux disease is unclear and studies have given conflicting results to date. Aim: To investigate whether Helicobacter pylori eradication causes gastroesophageal reflux disease determined by 24-hour pH monitorization. Metdods: 20 patients (12 men, mean age: 41, range 22-65 years) who were diagnosed duodenal ulcer disease by endoscopical examination and found to be Helicobacter pylori positive by means of CLO test, cytology, culture, with or without reflux symptoms were enrolled in the study. Eradication treatment (LAC: lansaprazol, amocsisilin, claritromisin 14 days) commenced after 24-hour pH monitorization and blood samples drawn for serum gastrin levels. Six months after the eradication treatment, endoscopical examination, 24-hour pH monitorization, serum gastrin levels and Helicobacter pylori tests repeated. Results: After six months 12 of 20 patients committed to reevaluation. Helicobacter pylori infection was eradicated successfully in two thirds of the patient population (66%). Reflux symptoms in eradicated patients before vs after treatment; 87.5% vs 37.5% (p=0.03), esophagitis 50% vs 50% (p>0.05), pH

Kaynakça

  • Vakil N. Gastroesophageal reflux disease and Helicobacter pylori infection. Rev Gastroenterol Disord 2003; 3:1-7
  • Janssens J, Sifrim D Spontaneous transient lower esophageal sphincter relaxations: a target for treatment of gastroesophageal reflux disease Gastroenterology 1995;109:1703-5
  • Mittal RK, Holloway RH, Penagini R, et al. Transient lower esophageal sphincter relaxation Gastroenterology 1995;109:601-10.
  • Genta RM, Huberman RM, Graham DY The gastric cardia in Helicobacter pylori. Human Pathol 1994;9:915-9.
  • Testoni PA, Bagnolo F, Masci E, et al. Different interdigestive antroduodenal motility patterns in chronic antral gastritis with and without Helicobacter pylori infection. Dig Dis Sci 1993;38:2255-61.
  • Koskonepato J, Korppi-Tommola T, et al. Long –therm follow up study of gastric emptying and Helicobacter pylori eradication among patient with functional dyspepsia Did Dis Sci 2000;45:1763-8.
  • Gutierrez O, Melo M, Segura AM, et al. Cure of Helicobacter pylori infection improves gastric acid secretion in patients with corpus gastritis. Scand J Gastroenterol 1997;32:664–8.
  • Wagner S, Haruma K, Gladziwa U et al. Helicobacter pylori infection and serum pepsinogen A, pepsinogen C, ve gastrin in gastritis and peptic ulcer: significance of inflammation and effect of bacterial eradication. Am J Gastroenterol 1994;89:1211-8.
  • Shiotani A, Nishioka S. Iguchi M et al. Duodenal erosions after eradication of helicobacter pylori infection Gastrointest Endosc 2001;54:448-53.
  • Tefera S, Hatlebakk J G, Berstad A. The effect of Helicobacter pylori eradication on gastroesophageal reflux. Aliment Pharmacol Ther 1999; 13: 915–20.
  • Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45:172–80.
  • Labenz J, Blum AL, Bayerdorffer E, et al. Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis. Gastroenterology 1997; 112: 1442–7.
  • McColl KE, Dickson A, El-Nujumi A, et al. Symptomatic benefit 1–3 years after H. pylori eradication in ulcer patients: impact of gastroesophageal reflux disease. Am J Gastroenterol 2000; 95: 101–5.
  • Vakil N, Hahn B, McSorley D. Recurrent symptoms and gastro-oesophageal reflux disease in patients with duodenal ulcer treated for Helicobacter pylori infection. Aliment Pharmacol Ther 2000; 14: 45–51.
  • Murai T, Miwa H, Ohkura R, et al. The incidence of reflux oesophagitis after cure of Helicobacter pylori in a Japanese population. Aliment Pharmacol Ther 2000;14:161–5.
  • Hurenkamp GJ, Grundmeijer HG, Bindels PJ, et al. Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study. Aliment Pharmacol Ther 2001; 15: 1047–54.
  • Raghunath AS, Hung›n APS, Wooff D, et al. Systematic review: the effect of Helicobacter pylori and its eradication on gastro-oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis Aliment Pharmacol Ther 2004; 20: 733–44.
  • Verma S, Jackson W, Floum S, et al. Gastroesophageal reflux before and after Helicobacter pylori eradication. A prospective study using ambulatory 24-h esophageal pH monitoring Diseases of the Esophagus 2003; 16, 273–8.
  • Iijima K, Ohara S, Sekine H, et al. Changes in gastric acid secretion assayed by endoscopic gastrin test before and after Helicobacter pylori eradication. Gut 2000;46:20–6.
  • Fukuchi T, Ashida K, Yamashita H, et al. Influence of cure of Helicobacter pylori infection on gastric acidity and gastroesophageal reflux: study by 24-h pH monitoring in patients with gastric or duodenal ulcer. J Gastroenterol 2005; 40:350–60
  • Tanaka I, Tatsumi Y, Kodama T, et al. Effect of Helicobacter pylori eradication on gastroesophageal function J Gastroenterol Hepatol 2004;19:251-7.
  • Graham DY, Opekum A, Lew GM, et al. Ablation of exaggerated meal stimulated gastrin relase in duodenal ulcer patients after clearance of Helicobacter pylori infection. Am J Gastroenterol 1990;85:394-8
  • El-Omar E, Penman I, Ardill J E, et al. Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease. Gastroenerol 1995; 109: 681–91.

Duodenal ülserli hastalarda Helikobakter pilori eradikasyonunun asit reflüsü üzerine etkisi

Yıl 2008, Cilt: 7 Sayı: 1, 34 - 38, 01.04.2008

Öz

Giriş ve Amaç: Helikobakter pilori infeksiyonunun gastroözofageal
hastal›ğa karş› koruduğu veya provake edip, etmediği belli değildir
ve yap›lan çal›şmalarda da tart›şmal› sonuçlar verilmektedir. Bu
çal›şmada Helikobakter pilori eradikasyonunun gastroözofageal reflüye
neden olup olmad›ğ› 24 saatlik özfagus pH monitorizasyonuyla
araşt›r›lm›şt›r. Gereç ve yöntem: Çal›şmaya endoskopide duodenal
ülser saptanan, CLO test, sitoloji ve kültürle Helikobakter pilori
infeksiyonu pozitif, reflü semptomlar› olan veya olmayan toplam 20
hasta (K/E: 8/12; yaş ortalamas›: 41 (22-65 y›l) al›nd›. Hastalara 24
saatlik pH monitorizasyonu ve serum gastrin düzeyi için kan al›nd›ktan
sonra eradikasyon tedavisi (LAK: lansaprazol, amoksisilin,
klaritromisin 14gün) verildi. Eradikasyon tedavisinden 6 ay sonra
endoskopik muayene, 24 saatlik pH monitorizasyonu, serum gastrin
düzeyi ve Helikobakter pilori testleri tekrarland›. Bulgular: 6 ay sonunda
20 hastan›n 12 tanesi yeniden değerlendirilebildi. 12 hastan›n
%66’s›nda Helikobakter pilori eradikasyonu başar›l› oldu. Eradikasyon
sağlanan hastalarda eflü semptomu %87’den, %37.5’e
(p=0,003); eroziv özofajit 50% 50% (p>0.05), pH

Kaynakça

  • Vakil N. Gastroesophageal reflux disease and Helicobacter pylori infection. Rev Gastroenterol Disord 2003; 3:1-7
  • Janssens J, Sifrim D Spontaneous transient lower esophageal sphincter relaxations: a target for treatment of gastroesophageal reflux disease Gastroenterology 1995;109:1703-5
  • Mittal RK, Holloway RH, Penagini R, et al. Transient lower esophageal sphincter relaxation Gastroenterology 1995;109:601-10.
  • Genta RM, Huberman RM, Graham DY The gastric cardia in Helicobacter pylori. Human Pathol 1994;9:915-9.
  • Testoni PA, Bagnolo F, Masci E, et al. Different interdigestive antroduodenal motility patterns in chronic antral gastritis with and without Helicobacter pylori infection. Dig Dis Sci 1993;38:2255-61.
  • Koskonepato J, Korppi-Tommola T, et al. Long –therm follow up study of gastric emptying and Helicobacter pylori eradication among patient with functional dyspepsia Did Dis Sci 2000;45:1763-8.
  • Gutierrez O, Melo M, Segura AM, et al. Cure of Helicobacter pylori infection improves gastric acid secretion in patients with corpus gastritis. Scand J Gastroenterol 1997;32:664–8.
  • Wagner S, Haruma K, Gladziwa U et al. Helicobacter pylori infection and serum pepsinogen A, pepsinogen C, ve gastrin in gastritis and peptic ulcer: significance of inflammation and effect of bacterial eradication. Am J Gastroenterol 1994;89:1211-8.
  • Shiotani A, Nishioka S. Iguchi M et al. Duodenal erosions after eradication of helicobacter pylori infection Gastrointest Endosc 2001;54:448-53.
  • Tefera S, Hatlebakk J G, Berstad A. The effect of Helicobacter pylori eradication on gastroesophageal reflux. Aliment Pharmacol Ther 1999; 13: 915–20.
  • Lundell LR, Dent J, Bennett JR, et al. Endoscopic assessment of oesophagitis: clinical and functional correlates and further validation of the Los Angeles classification. Gut 1999;45:172–80.
  • Labenz J, Blum AL, Bayerdorffer E, et al. Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis. Gastroenterology 1997; 112: 1442–7.
  • McColl KE, Dickson A, El-Nujumi A, et al. Symptomatic benefit 1–3 years after H. pylori eradication in ulcer patients: impact of gastroesophageal reflux disease. Am J Gastroenterol 2000; 95: 101–5.
  • Vakil N, Hahn B, McSorley D. Recurrent symptoms and gastro-oesophageal reflux disease in patients with duodenal ulcer treated for Helicobacter pylori infection. Aliment Pharmacol Ther 2000; 14: 45–51.
  • Murai T, Miwa H, Ohkura R, et al. The incidence of reflux oesophagitis after cure of Helicobacter pylori in a Japanese population. Aliment Pharmacol Ther 2000;14:161–5.
  • Hurenkamp GJ, Grundmeijer HG, Bindels PJ, et al. Arrest of chronic acid suppressant drug use after successful Helicobacter pylori eradication in patients with peptic ulcer disease: a six-month follow-up study. Aliment Pharmacol Ther 2001; 15: 1047–54.
  • Raghunath AS, Hung›n APS, Wooff D, et al. Systematic review: the effect of Helicobacter pylori and its eradication on gastro-oesophageal reflux disease in patients with duodenal ulcers or reflux oesophagitis Aliment Pharmacol Ther 2004; 20: 733–44.
  • Verma S, Jackson W, Floum S, et al. Gastroesophageal reflux before and after Helicobacter pylori eradication. A prospective study using ambulatory 24-h esophageal pH monitoring Diseases of the Esophagus 2003; 16, 273–8.
  • Iijima K, Ohara S, Sekine H, et al. Changes in gastric acid secretion assayed by endoscopic gastrin test before and after Helicobacter pylori eradication. Gut 2000;46:20–6.
  • Fukuchi T, Ashida K, Yamashita H, et al. Influence of cure of Helicobacter pylori infection on gastric acidity and gastroesophageal reflux: study by 24-h pH monitoring in patients with gastric or duodenal ulcer. J Gastroenterol 2005; 40:350–60
  • Tanaka I, Tatsumi Y, Kodama T, et al. Effect of Helicobacter pylori eradication on gastroesophageal function J Gastroenterol Hepatol 2004;19:251-7.
  • Graham DY, Opekum A, Lew GM, et al. Ablation of exaggerated meal stimulated gastrin relase in duodenal ulcer patients after clearance of Helicobacter pylori infection. Am J Gastroenterol 1990;85:394-8
  • El-Omar E, Penman I, Ardill J E, et al. Helicobacter pylori infection and abnormalities of acid secretion in patients with duodenal ulcer disease. Gastroenerol 1995; 109: 681–91.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Mehmet Bektaş Bu kişi benim

Murat Alkan Bu kişi benim

Yusuf Üstün Bu kişi benim

İrfan Soykan Bu kişi benim

Ali Özden Bu kişi benim

Yayımlanma Tarihi 1 Nisan 2008
Yayımlandığı Sayı Yıl 2008 Cilt: 7 Sayı: 1

Kaynak Göster

APA Bektaş, M., Alkan, M., Üstün, Y., Soykan, İ., vd. (2008). Duodenal ülserli hastalarda Helikobakter pilori eradikasyonunun asit reflüsü üzerine etkisi. Akademik Gastroenteroloji Dergisi, 7(1), 34-38.

test-5