Dysfunction of oesophageal motility in Helicobacter pylori-infected patients with reflux oesophagitis

Aliment Pharmacol Ther. 2001 Dec;15(12):1913-9. doi: 10.1046/j.1365-2036.2001.01132.x.


Background: Helicobacter pylori infection has been suggested to be protective against gastro-oesophageal reflux disease. However, a significant proportion of patients with gastro-oesophageal reflux disease are infected by H. pylori.

Aim: To study oesophageal motor function in H. pylori-infected patients with reflux oesophagitis.

Methods: Patients with erosive reflux oesophagitis were recruited prospectively for stationary oesophageal manometry and 24-h ambulatory oesophageal pH monitoring. H. pylori status was determined by biopsy urease test. Non-reflux volunteers were recruited as controls.

Results: Seventy-four patients with erosive oesophagitis (34 H. pylori-positive, 40 H. pylori-negative) and 48 non-reflux patient controls (22 H. pylori-positive, 26 H. pylori-negative) were recruited. There was no difference in severity of oesophagitis (median grade, 1; P=0.53) or oesophageal acid exposure (total percentage time oesophageal pH < 4, 7.6% vs. 6.8%; P=0.57) between H. pylori-positive and H. pylori-negative groups. Compared to H. pylori-negative patients, H. pylori-positive patients had significantly lower basal lower oesophageal sphincter pressure (12.2 mmHg vs. 15.3 mmHg; P=0.03) and amplitude of distal peristalsis (56.9 mmHg vs. 68.4 mmHg; P=0.03). Ineffective oesophageal motility (14% vs. 7%; P=0.02) and failed oesophageal peristalsis were also significantly more prevalent in H. pylori-positive patients.

Conclusions: Among patients with a similar degree of reflux oesophagitis, H. pylori-infected patients have more severe oesophageal dysmotility and lower oesophageal sphincter dysfunction. Oesophageal motor dysfunction probably plays a dominant role in the development of gastro-oesophageal reflux disease in patients with H. pylori infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Esophagitis, Peptic / microbiology
  • Esophagitis, Peptic / physiopathology*
  • Female
  • Gastritis / microbiology
  • Gastritis / physiopathology
  • Gastroesophageal Reflux / microbiology
  • Gastroesophageal Reflux / physiopathology*
  • Helicobacter Infections / microbiology
  • Helicobacter Infections / physiopathology*
  • Helicobacter pylori*
  • Humans
  • Male
  • Middle Aged