Review – H. pylori & non-malignant diseases

Abstract

The role of Helicobacter pylori in several non-malignant diseases affecting the upper gastrointestinal tract has been reviewed. The effects of H. pylori eradication on gastroesophageal reflux disease (GERD) and reflux laryngopharyngitis (RLP) remain controversial. Esophageal physiology tests and symptom score studies have suggested that H. pylori eradication may increase esophageal acid exposure and enhance symptoms. Regarding RLP, a retrospective study showed that compared to PPI treatment alone, H. pylori eradication yielded additional benefits in improving both the reflux symptom index and reflux finding score. Novel data have been presented for H. pylori and gastroduodenal diseases. The relationship between H. pylori infection and autoimmune gastritis (AIG) has been highlighted as a diagnostic marker for differentiating AIG from H. pylori-associated gastritis. A long-term study on the natural history of AIG, in which previous H. pylori infection was excluded, showed no association between AIG and excess of gastric cancer risk, and this finding has been extensively discussed. The link between duodenal eosinophils and mast cells in the pathogenesis of both functional-dyspepsia and H. pylori-associated dyspepsia has been investigated. Global studies have shown that the incidence of peptic ulcer disease continues to decline in the 21st century. A possible protective role of H. pylori eradication in reducing peptic ulcer bleeding in older patients using aspirin is presented. Finally, studies have analyzed the role of H. pylori eradication in early and long-term complications of bariatric surgery.

Keywords

• gastroesophageal reflux disease
• eosinophilic esophagitis
• autoimmune gastritis
• peptic ulcer
• dyspepsia
• bariatric surgery.