Should patients with gastroesophageal reflux disease eradicate Helicobacter pylori? Director | talked about digestion

Guide

It is said that the eradication of Helicobacter pylori will increase acid reflux heartburn, and Helicobacter pylori is the first carcinogenic factor of gastric cancer, so should patients with gastroesophageal reflux disease infected with Helicobacter pylori be eradicated?

Gastroesophageal reflux disease includes reflux esophagitis and gastroesophageal reflux signs.

Why does the incidence of gastroesophageal reflux disease increase after eradication of Helicobacter pylori (Hp) in Asian populations?

Gastroesophageal reflux disease is mainly the regurgitation of gastric acid into the esophagus, irritating the esophagus and causing symptoms such as acid reflux, heartburn, and retrosternal pain; it can be accompanied by or without esophageal inflammation and erosion ulcers.

Gastric acid is secreted by the floor of the stomach, the wall cells of the stomach body, if the chronic gastritis is based on the stomach floor and the stomach body after Hp infection, the wall cells are damaged, the number is reduced, and the secretion of gastric acid is reduced, so that the symptoms of gastroesophageal reflux disease are alleviated; after eradication of Hp, the inflammation of the gastric plantar gastric body is eliminated, the parietal cells are restored, and the gastric acid increases, which aggravates the symptoms of gastroesophageal reflux disease.

In Asian populations, there is more inflammation of the gastric floor, so gastroesophageal reflux disease with Hp infection in Asian populations may aggravate the symptoms of gastroesophageal reflux disease after eradication of Hp.

So, should people with gastroesophageal reflux disease with Hp infection eradicate Hp?

After 100% hp infection, it will cause active inflammation of the gastric mucosa, and long-term gastric mucosal inflammation is bound to lead to gastric mucosal atrophy and enteration, and even dysplasia and gastric cancer. It has been confirmed that Hp infection is the main factor inducing stomach cancer, and eradication of Hp can significantly reduce the incidence of stomach cancer!

Hp protects gastroesophageal reflux disease, not that Hp really plays a protective role, but at the cost of damaging the gastric mucosa and increasing the incidence of gastric cancer.

The main cause of gastroesophageal reflux disease is not excessive gastric acidity in the stomach, but a transient relaxation of the sphincter in the lower segment of the esophagus, which leads to acid reflux. Since there is currently no drug to tighten the lower esophageal sphincter, the treatment of gastroesophageal reflux disease is mainly to inhibit gastric acid with powerful acid suppressants (proton pump inhibitors) to alleviate the patient's reflux symptoms and damage to the esophagus. However, long-term acid suppression treatment will aggravate gastric atrophy and increase the incidence of gastric cancer, and if you add Hp infection, the incidence of gastric cancer will be higher.

Therefore, patients with gastroesophageal reflux disease and Hp infection are still better off eradicating Hp!