Long-term effect of Helicobacter pylori eradication on prevalence of reflux esophagitis

Background and Aim This study aimed to clarify the long-term effect of Helicobacter pylori eradication on the prevalence of reflux esophagitis (RE). Methods We enrolled 8123 individuals (male 5286, female 2837; mean age 54.2 +/- 9.3 years) who visited our medical center for an annual checkup between April 2016 and December 2018 and in whom the status of H. pylori infection could be determined. The presence of endoscopically proven RE was determined and compared based on that infection status. Results Reflux esophagitis was observed in 898 subjects (11.1%). The rates of prevalence in subjects without and with H. pylori infection and with a post-eradication status were 14.0%, 3.7%, and 10.1%, respectively (P < 0.001). Multiple logistic regression analysis of those positive for RE showed male gender, elevated body mass index, habitual drinking, habitual smoking, larger diaphragmatic hiatus size, and milder gastric mucosal atrophy to be significant risk factors. As compared with H. pylori negative, the odds ratios for H. pylori-positive and post-eradication status were 0.225 and 0.703, respectively. When post-eradication subjects were divided according to duration following eradication, RE prevalence was increased in association with a longer duration. Multiple logistic regression analysis revealed longer duration after H. pylori eradication to be a significant risk factor for RE. Conclusions The risk of RE developing in individuals following eradication of H. pylori is considered to be lower as compared with those never infected. However, the risk for RE increases as the period following H. pylori eradication is extended.