Raghunath A, Hungin APS, Wooff D, Childs S. Prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease: systematic review.
BMJ 2003;
326:737. [PMID:
12676842 PMCID:
PMC152634 DOI:
10.1136/bmj.326.7392.737]
[Citation(s) in RCA: 242] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/05/2003] [Indexed: 02/06/2023]
Abstract
OBJECTIVES
To ascertain the prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease and its association with the disease.
DESIGN
Systematic review of studies reporting the prevalence of H pylori in patients with and without gastro-oesophageal reflux disease.
DATA SOURCES
Four electronic databases, searched to November 2001, experts, pharmaceutical companies, and journals.
MAIN OUTCOME MEASURE
Odds ratio for prevalence of H pylori in patients with gastro-oesophageal reflux disease.
RESULTS
20 studies were included. The pooled estimate of the odds ratio for prevalence of H pylori was 0.60 (95% confidence interval 0.47 to 0.78), indicating a lower prevalence in patients with gastro-oesophageal reflux disease. Substantial heterogeneity was observed between studies. Location seemed to be an important factor, with a much lower prevalence of H pylori in patients with gastro-oesophageal reflux disease in studies from the Far East, despite a higher overall prevalence of infection than western Europe and North America. Year of study was not a source of heterogeneity.
CONCLUSION
The prevalence of H pylori infection was significantly lower in patients with than without gastro-oesophageal reflux, with geographical location being a strong contributor to the heterogeneity between studies. Patients from the Far East with reflux disease had a lower prevalence of H pylori infection than patients from western Europe and North America, despite a higher prevalence in the general population.
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