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Titolo:
Review article: is Helicobacter pylori status relevant in the management of GORD?
Autore:
Vigneri, S; Termini, R; Savarino, V; Pace, F;
Indirizzi:
Univ Palermo, Inst Internal Med, I-90127 Palermo, Italy Univ Palermo Palermo Italy I-90127 Internal Med, I-90127 Palermo, Italy L Sacco Univ Hosp, Gastrointestinal Unit, Milan, Italy L Sacco Univ Hosp Milan Italy Hosp, Gastrointestinal Unit, Milan, Italy Univ Genoa, Dept Internal Med, I-16126 Genoa, Italy Univ Genoa Genoa Italy I-16126 , Dept Internal Med, I-16126 Genoa, Italy
Titolo Testata:
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
, volume: 14, anno: 2000, supplemento:, 3
pagine: 31 - 42
SICI:
0269-2813(200010)14:<31:RAIHPS>2.0.ZU;2-8
Fonte:
ISI
Lingua:
ENG
Soggetto:
GASTROESOPHAGEAL REFLUX DISEASE; GASTRIC-ACID SECRETION; DUODENAL-ULCER PATIENTS; CAMPYLOBACTER-PYLORI; INTRAGASTRIC PH; ATROPHIC GASTRITIS; OMEPRAZOLE THERAPY; BARRETTS-ESOPHAGUS; SUPPRESSIVE THERAPY; CORPUS GASTRITIS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
100
Recensione:
Indirizzi per estratti:
Indirizzo: Vigneri, S Univ Palermo, Inst Internal Med, Via Vespro 141, I-90127 Palermo, Italy Univ Palermo Via Vespro 141 Palermo Italy I-90127 lermo, Italy
Citazione:
S. Vigneri et al., "Review article: is Helicobacter pylori status relevant in the management of GORD?", ALIM PHARM, 14, 2000, pp. 31-42

Abstract

There is growing interest in the relationship between H. pylori infection and gastro-oesophageal reflux disease (GORD). However, this relationship iscomplex, as yet not fully elucidated, and probably based on a multiplicityof factors. The prevalence of H. pylori infection in patients with GORD issimilar, more often lower than in matched controls. There is a negative correlation between H. pylori infection and the severity of GORD. There are many hypothetical mechanisms by which H. pylori infection may protect from the development of GORD. Conversely, there are many possible mechanisms by which H. pylori infection could theoretically foster the GORD. Patients after H. pylori eradication may develop GORD, and this seems to suggest a protective role of H. pylori infection, but other possible explanations include weight gain after H. pylori eradication, changes in dietary habits and smoking, and pre-existing GORD. H. pylori infected patients treated by various acid-inhibiting therapies such as proton pump inhibitors (PPIs). H-2-receptors antagonists (H-2-RA) orvagotomy, have an increase of their corpus gastritis severity. both in theactivity of inflammation and in the density of organisms. Long-term therapy of GORD in H. pylori infected may lead to rapid progression of atrophic gastritis intestinal metaplasia and dysplasia, and increase the risk of developing gastric cancer. More recently it has been shown that H. pylori infection may interfere with the acid suppressive therapies used for treating GORD. In our opinion the progression of gastritis depends on the threshold of acid output at which H. pylori can 'flourish'. Recently interest is growing on gastric transitional zones and Helicobacter ecology. Any decrease of acidsecretion changes the behaviour of H. pylori: the activity of gastritis improves in the antrum, but it deteriorates in the body. During proton pump inhibitor treatment, H. pylori redistribution occurs within the stomach, from an antral to a corpus or fundus prevalent pattern: corpus-fundus gastritis, exacerbated by PPI therapy, may result both in a diminished acid secretion and gastro-oesophageal reflux. The interest in Barrett's oesophagus is growing due to the associated riskof adenocarcinoma. The literature seems to demonstrate that the prevalenceof H. pylori infection of the stomach in Barrett's oesophagus patients is not different from that exhibited by controls, roughly one-third of the subjects. Intestinal metaplasia of the gastric cardia seems to be equally frequent in patients with and without GORD. Finally, it appears unlikely that acausal relationship exists between H. pylori infection and Barrett's-associated adenocarcinoma.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 10:18:27