Review: Helicobacter pylori and non-malignant upper gastrointestinal diseases.

Abstract

This review covers recent publications investigating the relationship between Helicobacter pylori infection and gastroesophageal reflux disease, Barrett's esophagus, eosinophilic esophagitis, peptic ulcer disease (PUD), Hpylori gastritis, and functional dyspepsia. In the area of gastroesophageal reflux disease, new data suggest that reflux may have a role in the transmission of Hpylori infection. In addition to several observational studies, data on alterations in esophageal physiology in patients with Hpylori infection are presented. Further evidence for the inverse relationship between Hpylori infection and Barrett's esophagus is available in the form of a meta-analysis from the North American Barrett's and Esophageal Carcinoma Consortium. The relationship between Hpylori infection and eosinophilic esophagitis remains uncertain. Although new data do not indicate a significantly lower prevalence of Hpylori among patients with eosinophilic esophagitis, a meta-analysis showed a 37% reduced risk of eosinophilic esophagitis among Hpylori-infected patients. Novel data are presented on the genetic variability of bacterial virulence factors and their relationship with PUD. We also report data on plasma biomarkers, which may detect progression to gastric cancer in Hpylori-associated PUD. A new meta-analysis was published, which assessed the risk of PUD in low-dose aspirin users with Hpylori infection. Finally, we report on the ongoing attempts to stratify patients with gastritis using endoscopic methods when compared to standard biopsy examination.