EROZİV ÖZOFAJİT GELİŞİMİNDE HELİCOBACTER PYLORİ’NİN GASTRİK LOKALİZASYONUN VE GASTRİT SKORUNUN ROLÜ

Amaç: Helicobacter pylori (Hp) enfeksiyonu ve gastroözofageal reflü hastalığı (GÖRH) dünya çapında yaygın hastalıklardır. Hp ve GÖRH arasındaki etkileşim ise karmaşık bir konudur. Bu çalışmanın amacı erişkin hastalarda Hp enfeksiyonu ve Hp’nin gastrik lokalizasyonu ile reflü özefajit arasındaki ilişkiyi araştırmaktır. Gereç ve Yöntem: Reflü özofajit tanılı 239 hasta, 229 yaş ve cinsiyet uyumlu kontrol grubu ile karşılaştırıldı. Gastrik antrum ve korpustan elde edilen biyopsi örnekleri histolojik olarak değerlendirildi. Enflamasyon, aktivite ve Hp kolonizasyonunun ciddiyeti, 0 (hiçbiri) ile 3 (en ağır) arasında skorlandı. Enflamasyon ve aktivite skorları toplandı ve gastrit skoru olarak ifade edildi. Bulgular: Hp enfeksiyonu prevalansı RE’li hastalarda kontrol grubuna göre anlamlı olarak düşüktü (olasılık oranı 1,56 %95 güven aralığı 1,08-2,27; p=0,02, p0,05). Korpustaki Hp kolonizasyonu ve gastrit skorunun özofajit gelişimi ile negatif korelasyon gösterdiği, antrum ve gastrit skorundaki Hp kolonizasyonunun özofajit ile korelasyon göstermediği bulundu. Sonuç: Sonuç olarak, bu çalışmada Hp enfeksiyonu ve korpus gastrit skoru sıklığının, eroziv reflü özofajit hastalarında kontrol grubuna göre anlamlı derecede düşük olduğu gösterilmiştir. Ayrıca, Hp kolonizasyonu ve korpus gastrit skorunun özofajit gelişimi ile negatif korele olduğunu göstermiştir.

Anahtar Kelimeler:

Helicobacter pylori, Reflü özofajit, GÖRH, Korpus dominant gastrit

THE ROLE OF GASTRIC LOCALIZATION AND THE GASTRITIS SCORE OF HELICOBACTER PYLORI IN THE DEVELOPMENT OF EROSIVE ESOPHAGITIS

Objective: The interactions between Helicobacter pylori (Hp) and gastroesophageal reflux disease (GERD) are a complex issue. The aim of this study was to investigate the correlation between Hp infection and the gastric localization of Hp and reflux esophagitis (RE) in adult patients. Material and Method: Two hundred thirty-nine patients with RE were compared with 229 age and sex matched participants in a control group. Biopsy specimens obtained from the gastric antrum and corpus were histologically evaluated. Results: The prevalence of Hp infection was significantly lower in the patients with RE than in the control group (Odds ratio 1.56, 95% CI 1.08-2.27; p=0.02, p

Keywords:

Helicobacter pylori, Reflux esopfagitis, GERD, Corpus dominant gastritis,

PDF

___

1. Adachi K, Notsu T, Mishiro T, Kinoshita Y. Long-term effect of Helicobacter pylori eradication on prevalence of reflux esophagitis. J Gastroenterol Hepatol 2019;34(11):1963-7. [CrossRef]
2. Kim BJ, Cheon WS, Oh HC, Kim JW, Park JD, Kim JG. Prevalence and risk factor of erosive esophagitis observed in Korean National Cancer Screening Program. J Korean Med Sci 2011;26(5):642-6. [CrossRef]
3. Kinoshita Y, Adachi K, Fujishiro H. Therapeutic approaches to reflux disease, focusing on acid secretion. J Gastroenterol 2003;38(S15):13-9.
4. Malfertheiner P, Megraud F, O’Morain CA, Gisbert JP, Kuipers EJ, Axon AT, et al. European Helicobacter and Microbiota Study Group and Consensus panel. Management of Helicobacter pylori infection-the Maastricht V/Florence Consensus Report Gut 2017;66(1):6-30.
5. Yucel O. Interactions between Helicobacter pylori and gastroesophageal reflux disease. Esophagus 2019;16(1):5262. [CrossRef]
6. Mungan Z, Pınarbaşı SB. Gastroesophageal reflux disease and the relationship with Helicobacter pylori. Turk J Gastroenterol 2017;28(S1):61-7. [CrossRef]
7. Labenz J, Blum AL, Bayerdörffer E, Meining A, Stolte M, Börsch G. Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis. Gastroenterology 1997;112(5):1442-7. [CrossRef]
8. Raghunath A, Hungin AP, Wooff D, Childs S. Prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease: systematic review. BMJ 2003;326(7392):737. [CrossRef]
9. Haruma K. Review article: influence of Helicobacter pylori on gastro-oesophageal reflux disease in Japan. Aliment Pharmacol Ther 2004;20 (S8):40-4. [CrossRef]
10. Take S, Mizuno M, Ishiki K, Nagahara Y, Yoshida T, Yokota K, et al. Helicobacter pylori eradication may induce de novo, but transient and mild, reflux esophagitis: Prospective endoscopic evaluation. J Gastroenterol Hepatol 2009;24(1):107-13. [CrossRef]
11. Koike T, Ohara S, Sekine H, Iijima K, Abe Y, Kato K, et al. Helicobacter pylori infection prevents erosive reflux oesophagitis by decreasing gastric acid secretion. Gut 2001;49(3):330-4. [CrossRef]
12. Sugimoto M, Uotani T, Ichikawa H, Andoh A, Furuta T. Gastroesophageal Reflux Disease in Time Covering Eradication for All Patients Infected with Helicobacter pylori in Japan. Digestion 2016;93(1):24-31. [CrossRef]
13. Dixon MF, Genta RM, Yardley JH, Correa P. Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis, Houston 1994. Am J Surg Pathol 1996 ;20(10):1161-81. [CrossRef]
14. Schwizer W, Thumshirn M, Dent J, Guldenschuh I, Menne D, Cathomas G, et al. Helicobacter pylori and symptomatic relapse of gastro-oesophageal reflux disease: a randomised controlled trial. Lancet 2001;357(9270):1738-42. [CrossRef]
15. Xue Y, Zhou LY, Lin SR, Hou XH, Li ZS, Chen MH, et al. Effect of Helicobacter pylori eradication on reflux esophagitis therapy: a multi-center randomized control study. Chin Med J (Engl) 2015;128(8):995-9. [CrossRef]
16. Fallone CA, Barkun AN, Friedman G, Mayrand S, Loo V, Beech R, et al. Is Helicobacter pylori eradication associated with gastroesophageal reflux disease? Am J Gastroenterol 2000;95(4):914-20. [CrossRef]
17. Befrits R, Sjöstedt S, Odman B, Sörngård H, Lindberg G. Curing Helicobacter pylori infection in patients with duodenal ulcer does not provoke gastroesophageal reflux disease. Helicobacter 2000;5(4):202-5. [CrossRef]
18. Moschos JM, Kouklakis G, Vradelis S, Zezos P, Pitiakoudis M, Chatzopoulos D, et al. Patients with established gastroesophageal reflux disease might benefit from Helicobacter pylori eradication. Ann Gastroenterol 2014;27(4):352-6.
19. DeKoster E, Ferhat M, Deprez C, Deltenre M. H. pylori, gastric histology and gastro-oesophageal reflux disease. Gut 1995;37(S1):A36.
20. Manes G, Mosca S, Laccetti M, Lioniello M, Balzano A. Helicobacter pylori infection, pattern of gastritis, and symptoms in erosive and nonerosive gastroesophageal reflux disease. Scand J Gastroenterol 1999;34(7):658-62. [CrossRef]
21. Graham DY, Yamaoka YH. H. Pylori and cagA: relationship with gastric cancer, duodenal ulcer, and reflux esophagitis and its complications. Helicobacter 1998;3:145-51. [CrossRef]
22. Iijima K, Koike T, Shimosegawa T. Reflux esophagitis triggered after Helicobacter pylori eradication: a noteworthy demerit of eradication therapy among the Japanese? Front Microbiol 2015;6:566. [CrossRef]