Colonization with <i>cag</i>A-Positive <i>Helicobacter pylori</i> Strains Inversely Associated with Reflux Esophagitis and Barrett’s Esophagus

Abstract Background: Reflux esophagitis (RE) and absence of Helicobacter pylori (non-H. pylori) are considered to be associated with the progression to long-segment Barrett’s esophagus (LSBE). However, it is difficult to assess this association because RE and H. pylori status can change during follow-up. Additionally, the association between H. pylori eradication and LSBE remains unclear. Methods: A total of 11,493 asymptomatic Japanese subjects who underwent medical check-ups and were endoscopically diagnosed with short-segment Barrett’s esophagus (SSBE) between May 2006 and December 2015 were enrolled. The hazards of progression to LSBE were compared between time-varying RE and H. pylori infection/eradication by time-dependent multivariable Cox proportional hazards models. Results A total of 7,637 subjects who underwent additional medical check-ups after being diagnosed with endoscopic SSBE were analyzed. Subjects with RE and without current/past H. pylori infection were strongly associated with a higher rate of progression to LSBE (adjusted hazard ratio [HR]: 7.17, 95% confidence interval [CI]: 2.48–20.73, p < 0.001 for RE and non-H. pylori vs. non-RE and H. pylori groups). Subjects with H. pylori had a lower rate of progression to LSBE (adjusted HR: 0.48, 95% CI: 0.22–1.07, p = 0.07 for H. pylori vs. non-H. pylori). Hazards of progression to LSBE were still lower in the H. pylori eradication group than that of the non-H. pylori group (adjusted HR: 0.51, 95% CI: 0.18–1.46, p = 0.21). Conclusions RE and non-H. pylori were associated with the progression to LSBE, considering the changes in exposures. H. pylori eradication may not increase the rate of progression to LSBE.

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Barrett's Esophagus in an Area with an Exceptionally Low Prevalence of Helicobacter pylori Infection

ISRN Gastroenterology ◽

10.5402/2011/394734 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 6

Author(s):

Yeong Yeh Lee ◽

Sharifah Emilia Tuan Sharif ◽

Syed Hassan Syed Abd Aziz ◽

S. Mahendra Raj

Keyword(s):

Helicobacter Pylori ◽

Barrett’S Esophagus ◽

Reflux Esophagitis ◽

Barrett's Esophagus ◽

Urease Test ◽

Columnar Lined Esophagus ◽

H Pylori ◽

A Minor ◽

Low Prevalence ◽

Endoscopic Esophagitis

Objective. This study was undertaken to gain an insight into the relationship between Helicobacter pylori (H. pylori) infection, Barrett's esophagus and reflux esophagitis in an area of exceptionally low prevalence of H. pylori infection. Methods. A total of 1895 consecutive upper endoscopies performed between January 2005 and July 2007 were reviewed. 120 cases of columnar-lined esophagus and endoscopic esophagitis were evaluated. H. pylori infection was determined using the urease test and/or histology. Results. The rate of endoscopic esophagitis was 5.49% (80 Malays, 24 non-Malays) while histological reflux esophagitis was found in 3.75% (56 Malays, 15 non-Malays). Barrett's esophagus was present in 0.79% (11 Malays, 4 non-Malays). H. pylori infection was present in 8/120 or 6.67% subjects. Conclusion. The low rate of Barrett's esophagus in this population does not support the hypothesis that the absence of H. pylori infection is more than a minor risk factor for Barrett's esophagus.

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Relationship between time-varying status of reflux esophagitis and Helicobacter pylori and progression to long-segment Barrett’s esophagus: time-dependent Cox proportional-hazards analysis

BMC Gastroenterology ◽

10.1186/s12876-020-01418-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Genki Usui ◽

Tomohiro Shinozaki ◽

Toyohisa Jinno ◽

Kazutoshi Fujibayashi ◽

Teppei Morikawa ◽

...

Keyword(s):

Helicobacter Pylori ◽

Barrett’S Esophagus ◽

Reflux Esophagitis ◽

Barrett's Esophagus ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Time Dependent ◽

Time Varying

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Relationship between time-varying status of reflux esophagitis and Helicobacter pylori and progression to long-segment Barrett’s esophagus: time-dependent Cox proportional-hazards analysis

10.21203/rs.3.rs-22384/v3 ◽

2020 ◽

Author(s):

Genki Usui ◽

Tomohiro Shinozaki ◽

Toyohisa Jinno ◽

Kazutoshi Fujibayashi ◽

Teppei Morikawa ◽

...

Keyword(s):

Helicobacter Pylori ◽

Barrett’S Esophagus ◽

Reflux Esophagitis ◽

Barrett's Esophagus ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Time Dependent ◽

Time Varying ◽

Rate Of Progression ◽

H Pylori

Abstract Background: Reflux esophagitis (RE) and absence of Helicobacter pylori (non-H. pylori) are considered to be associated with the progression to long-segment Barrett’s esophagus (LSBE). However, it is difficult to assess this association because RE and H. pylori status can change during follow-up. Additionally, the association between H. pylori eradication and LSBE remains unclear.Methods: A total of 11,493 asymptomatic Japanese subjects who underwent medical check-ups and were endoscopically diagnosed with short-segment Barrett’s esophagus (SSBE) between May 2006 and December 2015 were enrolled. The hazards of progression to LSBE were compared between time-varying RE and H. pylori infection/eradication by time-dependent multivariable Cox proportional hazards models.Results: A total of 7,637 subjects who underwent additional medical check-ups after being diagnosed with endoscopic SSBE were analyzed. Subjects with RE and without current/past H. pylori infection were strongly associated with a higher rate of progression to LSBE (adjusted hazard ratio [HR]: 7.17, 95% confidence interval [CI]: 2.48-20.73, p<0.001 for RE and non-H. pylori vs. non-RE and H. pylori groups). Subjects with H. pylori had a lower rate of progression to LSBE (adjusted HR: 0.48, 95% CI: 0.22-1.07, p=0.07 for H. pylori vs. non-H. pylori). Hazards of progression to LSBE were still lower in the H. pylori eradication group than that of the non-H. pylori group (adjusted HR: 0.51, 95% CI: 0.18-1.46, p=0.21).Conclusions: RE and non-H. pylori were associated with the progression to LSBE, considering the changes in exposures. H. pylori infection was associated with the prevention of the development of LSBE irrespective of RE. The environment preventive of the development of LSBE persists for at least a few years after H. pylori eradication.

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Relationship between time-varying status of reflux esophagitis and Helicobacter pylori and progression to long-segment Barrett’s esophagus: time-dependent Cox proportional-hazards analysis

10.21203/rs.3.rs-22384/v2 ◽

2020 ◽

Author(s):

Genki Usui ◽

Tomohiro Shinozaki ◽

Toyohisa Jinno ◽

Kazutoshi Fujibayashi ◽

Teppei Morikawa ◽

...

Keyword(s):

Helicobacter Pylori ◽

Barrett’S Esophagus ◽

Reflux Esophagitis ◽

Barrett's Esophagus ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Time Dependent ◽

Time Varying ◽

Rate Of Progression ◽

H Pylori

Abstract Background: Reflux esophagitis (RE) and absence of Helicobacter pylori (non-H. pylori) are considered to be associated with the progression to long-segment Barrett’s esophagus (LSBE). However, it is difficult to assess this association because RE and H. pylori status can change during follow-up. Additionally, the association between H. pylori eradication and LSBE remains unclear.Methods: A total of 11,493 asymptomatic Japanese subjects who underwent medical check-ups and were endoscopically diagnosed with short-segment Barrett’s esophagus (SSBE) between May 2006 and December 2015 were enrolled. The hazards of progression to LSBE were compared between time-varying RE and H. pylori infection/eradication by time-dependent multivariable Cox proportional hazards models.Results: A total of 7,637 subjects who underwent additional medical check-ups after being diagnosed with endoscopic SSBE were analyzed. Subjects with RE and without current/past H. pylori infection were strongly associated with a higher rate of progression to LSBE (adjusted hazard ratio [HR]: 7.17, 95% confidence interval [CI]: 2.48-20.73, p<0.001 for RE and non-H. pylori vs. non-RE and H. pylori groups). Subjects with H. pylori had a lower rate of progression to LSBE (adjusted HR: 0.48, 95% CI: 0.22-1.07, p=0.07 for H. pylori vs. non-H. pylori). Hazards of progression to LSBE were still lower in the H. pylori eradication group than that of the non-H. pylori group (adjusted HR: 0.51, 95% CI: 0.18-1.46, p=0.21).Conclusions: RE and non-H. pylori were associated with the progression to LSBE, considering the changes in exposures. H. pylori infection was associated with the prevention of the development of LSBE irrespective of RE. The environment preventive of the development of LSBE persists for at least a few years after H. pylori eradication.

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