Patients with established gastro-esophageal reflux disease might benefit from eradication.

BACKGROUND

The aim of this study was to investigate the effect of () eradication in selected -positive patients with a primary diagnosis of gastro-esophageal reflux disease (GERD) by using the 3-h postprandial esophageal pH monitoring.

METHODS

We recruited patients with erosive esophagitis at endoscopy and infection at histology, successfully cured following eradication therapy; the selected -positive patients had weekly reflux symptoms for at least six months and endoscopically established Grade A or B esophagitis. Twenty-nine eligible patients were initially subjected to esophageal manometry and ambulatory 3-h postprandial esophageal pH monitoring. All patients received triple eradication therapy accompanied by successful eradication. After successful eradication of (confirmed by C urea breath test), a second manometry and 3-h postprandial esophageal pH monitoring were introduced to assess the results of eradication therapy, after a 3-month post-treatment period.

RESULTS

All 29 selected -positive patients became negative due to successful eradication, evaluated by C urea breath test after a 4-week post-treatment period. Post-eradication, 62.1% patients showed similar manometric pattern at baseline; 17.2% showed improvement; 17.2% normalization; and 3.4% deterioration of the manometric patterns. The DeMeester symptom scoring in the 3-h postprandial ambulatory esophageal pH monitoring was improved after eradication of (median 47.47 vs. 22.00, Wilcoxon's singed rank; P=0.016). On comparing the pH monitoring studies for each patient at baseline and post-eradication period, 82.8% patients showed improvement and 17.2% deterioration of the DeMeester score.

CONCLUSION

By using 3-h postprandial esophageal pH monitoring, this study showed, for the first time, that eradication may positively influence GERD symptoms. Large-scale controlled relative studies are warranted to confirm these findings.