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Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

Clin.Gastroenterol.Hepatol.

Feb

12

2

239

245

LR: 20150423; CI: Copyright (c) 2014; GR: K23 DK079291/DK/NIDDK NIH HHS/United States; GR: K23DK079291/DK/NIDDK NIH HHS/United States; GR: K24 DK080941/DK/NIDDK NIH HHS/United States; GR: K24DK080941/DK/NIDDK NIH HHS/United States; GR: P30 DK034933/DK/NID

United States

1542-7714; 1542-3565

PMID: 23988686

eng

Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; IM

10.1016/j.cgh.2013.08.029 [doi]

Unknown(0)

23988686

BACKGROUND & AIMS: Infection with Helicobacter pylori, particularly the cytotoxin-associated gene A (cagA)+ strain, is believed to protect against Barrett's esophagus, but it is not clear if it protects against gastroesophageal reflux disease (GERD). We aimed to determine whether H pylori infection is associated with GERD symptoms, erosive esophagitis, and Barrett's esophagus within the same cohort. METHODS: We analyzed data from a case-control study of 533 men (ages, 50-79 y) who underwent colorectal cancer screening at 2 tertiary medical centers in Michigan between 2008 and 2011 and who also were recruited to undergo upper endoscopy. We assessed 80 additional men found to have Barrett's esophagus during clinically indicated upper-endoscopy examinations. Logistic regression was used to estimate the associations between serum antibodies against H pylori or cagA and GERD symptoms, esophagitis, and Barrett's esophagus, compared with randomly selected men undergoing colorectal cancer screens (n = 177). RESULTS: H pylori infection was associated inversely with Barrett's esophagus (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.29-0.97), particularly the cagA+ strain (OR, 0.36; 95% CI, 0.14-0.90). There was a trend toward an inverse association with erosive esophagitis (H pylori OR, 0.63; 95% CI, 0.37-1.08; and cagA+ OR, 0.47; 95% CI, 0.21-1.03). However, GERD symptoms were not associated with H pylori infection (OR, 0.948; 95% CI, 0.548-1.64; and cagA+ OR, 0.967; 95% CI, 0.461-2.03). CONCLUSIONS: Based on a case-control study, infection with H pylori, particularly the cagA+ strain, is associated inversely with Barrett's esophagus. We observed a trend toward an inverse association with esophagitis, but not with GERD symptoms.

AGA Institute. Published by Elsevier Inc

Rubenstein,J.H., Inadomi,J.M., Scheiman,J., Schoenfeld,P., Appelman,H., Zhang,M., Metko,V., Kao,J.Y.

Center for Clinical Management Research, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan; Division of Gastroenterology, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan. Electronic address: jhr@umi

20130827

PMC3947027

http://vp9py7xf3h.search.serialssolutions.com/?charset=utf-8&pmid=23988686

2014