Helicobacter Pylori Infection and Gastroesophageal Reflux Disease - Barrett's Esophagus - Esophageal Carcinoma Sequence pp. 245-264
Authors: (Jannis Kountouras, Dimitrios Chatzopoulos, Christos Zavos, Elena Tsiaousi, Panagiotis Katsinelos, Dimitrios Tzilves, Nikolaos Zavos, Stergios Polyzos, George Kouklakis, John Moschos, Ioannis Venizelos, Maria Tzitiridou, Department of Gastroenterology, Second Medical Clinic, Aristotle University of Thessaloniki, Ippokration Hospital, Thessaloniki, Greece)
Abstract: Barrett‘s esophagus (BE), or replacement of the squamous mucosa by specialized intestinal metaplasia, is a complication of long-standing gastro-esophageal reflux disease (GERD) and a well-recognized premalignant condition playing a pivotal role in esophageal adenocarcinoma (EA) development. GERD plays a crucial role in the pathophysiology and the clinical identification of BE which represents the most serious histologic consequence of chronic GERD; GERD is an important risk factor for EA that develops in BE patients, and an increased incidence of GERD, BE and EA has been observed in the developed world. In this regard, our recent data show that Helicobacter pylori (H. pylori) infection is frequent in GERD, even in non-endoscopical (non-erosive) reflux disease and BE patients, and H. pylori eradication leads to a better control of GERD symptoms and improves esophagitis. Other authors also reported improvement in reflux symptoms following H. pylori treatment. A great body of recent evidence further potentiates the concern that H. pylori is now not ―protective‖ against GERD and seems to be involved in the GERD-BE-EA sequence.