From the Guidelines
No, there is no direct association between H. pylori and GERD that suggests H. pylori causes GERD, and current evidence indicates that H. pylori infection may actually protect against GERD in some individuals. The relationship between Helicobacter pylori (H. pylori) and Gastroesophageal Reflux Disease (GERD) is complex and somewhat paradoxical. When H. pylori colonizes the stomach, particularly strains that cause corpus-predominant gastritis, it can reduce acid production, which may decrease the likelihood or severity of GERD symptoms 1. This protective effect becomes especially apparent after H. pylori eradication therapy, as some patients develop new-onset GERD or experience worsening of existing GERD symptoms following successful treatment of their H. pylori infection. The mechanism involves the restoration of normal acid production in the stomach after eliminating the bacteria. However, this relationship varies depending on the pattern of gastritis caused by H. pylori and individual patient factors.
Some studies have suggested that the eradication of H. pylori does not induce or worsen GORD, but rather, the presence of H. pylori might have a protective effect against the development of GERD 1. It's also important to consider that H. pylori eradication remains essential when indicated (for peptic ulcer disease, gastric MALT lymphoma, or as part of gastric cancer prevention), despite the potential risk of developing or worsening GERD. Patients undergoing H. pylori eradication should be monitored for GERD symptoms, and appropriate acid-suppressive therapy should be initiated if reflux symptoms develop after treatment.
Key points to consider include:
- The complex relationship between H. pylori and GERD
- The potential protective effect of H. pylori against GERD
- The importance of monitoring for GERD symptoms after H. pylori eradication
- The need for individualized treatment approaches based on patient factors and the pattern of gastritis caused by H. pylori. Given the most recent and highest quality evidence, the association between H. pylori and GERD is not straightforward, and H. pylori infection may actually have a protective effect against GERD in some individuals 1.
From the Research
Association between H. pylori and GERD
- There is no direct evidence in the provided studies to support an association between Helicobacter pylori (H. pylori) and Gastroesophageal Reflux Disease (GERD) 2, 3, 4, 5, 6.
- The studies focus on the relationship between H. pylori and other conditions, such as gastrointestinal symptoms in children 2, Guillain-Barré Syndrome 3, vitamin B12 levels 4, nonalcoholic fatty liver 5, and coronary artery disease 6.
- None of the studies explicitly investigate the link between H. pylori and GERD, making it difficult to draw a conclusion about their association.
- Further research is needed to determine if there is a relationship between H. pylori infection and GERD.