Randomised controlled trial of effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux: Bristol helicobacter project
Objectives To investigate the effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux. Design Cross sectional study, followed by a randomised placebo controlled trial. Setting Seven general practices in Bristol, England. Participants 10 537 people, age...
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| Published in | BMJ Vol. 328; no. 7453; p. 1417 |
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| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
BMJ Publishing Group Ltd
12.06.2004
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| Subjects | |
| Online Access | Get full text |
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| Summary: | Objectives
To investigate the effects of
Helicobacter pylori
infection and its eradication on heartburn and gastro-oesophageal reflux.
Design
Cross sectional study, followed by a randomised placebo controlled trial.
Setting
Seven general practices in Bristol, England.
Participants
10 537 people, aged 20-59 years, with and without
H pylori
infection (determined by the
13
C-urea breath test).
Main outcome measures
Prevalence of heartburn and gastro-oesophageal acid reflux at baseline and two years after treatment to eradicate
H pylori
infection.
Results
At baseline,
H pylori
infection was associated with increased prevalence of heartburn (odds ratio 1.14, 95% confidence interval 1.05 to 1.23) but not reflux (1.05, 0.97 to 1.14). In participants with
H pylori
infection, active treatment had no effect on the overall prevalence of heartburn (0.99, 0.88 to 1.12) or reflux (1.04, 0.91 to 1.19) and did not improve pre-existing symptoms of heartburn or reflux.
Conclusions
H pylori
infection is associated with a slightly increased prevalence of heartburn but not reflux. Treatment to eradicate
H pylori
has no net benefit in patients with heartburn or gastro-oesophageal reflux. |
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| Bibliography: | Correspondence to: R F Harvey richard.harvey1@virgin.net We thank the participants in the Bristol helicobacter project and the general practitioners and health centre staff; the nursing team of Lynne Bradshaw, Julie Watson, Tina Critchley, Jo Lee, Carol Everson-Coombe, Penny Nettlefield, and Joanne Smith; Judy Millward, Helen Davies, Amy Hawkins, and Sarah Pike for secretarial support; and Erwin Brown, Paul Thomas, Nick Pope, and Phil Hedges of the microbiology department and Peter Spurr, Martin Bullock, and Fiona Greenwood of the pharmacy department, Frenchay Hospital, for help with the breath tests. Ethical approval: The local research ethics committee approved the study. Contributors: RFH initiated the study, helped to plan the project, analysed the results, wrote the initial draft of the paper, and is the guarantor. JAL ran the Bristol helicobacter project from day to day and helped with analysis of the data and the final version of the paper. PN helped to set up the project. LJM, IMH, and JLD helped to plan the project, analyse the results, and produce the final version of the paper. Competing interests: RFH and JAL were reimbursed by GlaxoSmithKline for attending the AGA symposium in 2000. Funding: This study was funded jointly by the NHS South and West Regional Research and Development Directorate and GlaxoSmithKline UK. The Department of Social Medicine is the lead centre for the MRC Health Services Research Collaboration. |
| ISSN: | 0959-8138 1468-5833 |
| DOI: | 10.1136/bmj.38082.626725.EE |