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. 2003 Apr 5;326(7392):737.
doi: 10.1136/bmj.326.7392.737.

Prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease: systematic review

Anan Raghunath  1 , A Pali S Hungin, David Wooff, Susan Childs
Affiliations

Prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease: systematic review

Anan Raghunath et al. BMJ. .

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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Figures

Figure 1
Figure 1
Odds ratios (95% confidence intervals) for prevalence of H pylori infection, grouped by geographical location. Large boxes indicate studies with small standard errors (essentially larger sample sizes) and vertical dotted line indicates no difference between groups
Figure 2
Figure 2
Size and effect of results from eligible studies of prevalence of H pylori infection in patients with and without gastro-oesophageal reflux disease
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