The Effect of Helicobacter pylori Eradication in Patients with Gastroesophageal Reflux Disease: A Meta-Analysis of Randomized Controlled Studies

Abstract

Aim:Helicobacter pyloriinfection has been established as a definite risk factor for gastric cancer. However, the consequence ofH. pylorieradication on the progression of gastroesophageal reflux disease (GERD) remains controversial. The purpose of our study was to investigate the relationship betweenH. pylorieradication and the development of GERD.Methods:A comprehensive, English literature search was performed from January 1990 to April 2019. Only randomized controlled trials (RCT) that evaluated the effect ofH. pylorieradication on GERD were included. Meta-analysis of pooled OR was performed using Review Manger 5.1.7.Results:Seventeen articles with 6,889 subjects (intention-to-treat) that fulfilled the inclusion criteria were finally included in the analysis. Of them, 8 RCTs have the similar study design and inclusion criterion, which included patients withH. pyloriinfection but without GERD at baseline. The OR for the development of erosive GERD afterH. pylorieradication was 1.67 (95% CI 1.12-2.48,p= 0.01). The OR for the development of GERD-related symptoms afterH. pylorieradication in eradication group compared with control group was 1.04 (95% CI 0.84-1.29,p= 0.71). In addition, 9 RCTs included patients with both baselineH. pyloriinfection and GERD. The OR for the healing rates and relapse rates afterH. pylorieradication in theH. pylorieradication group vs. control group was 0.92 (95% CI 0.47-1.82,p= 0.82) and 1.12 (95% CI 0.60-2.09,p= 0.71), respectively.Conclusions:Our meta-analyses showedH. pylorieradication may lead to the development of new erosive GERD. However, eradication ofH. pylorimay affect neither the healing rates nor relapse rates of preexisting GERD.