Helicobacter pylori eradication does not worsen quality of life related to reflux symptoms: A prospective trial

Abstract

Background: Concern has been raised that Helicobacter pylori therapy may lead to the development of gastrooesophageal reflux disease. This prospective study was designed to assess reflux-related quality of life and the symptoms of gastro-oesophageal reflux disease in patients undergoing H. pylori therapy. Methods: Patients with a primary complaint of dyspepsia (upper abdominal pain or discomfort) and endoscopic biopsy positive for H. pylori received triple therapy for 2 weeks. A validated reflux-related quality of life questionnaire sensitive to change was given at baseline, 1 month and 6 months after therapy; symptoms were also recorded. A urea breath test was performed 1 month after the end of therapy; patients and investigators were blind to the results. Results: H. pylori was eradicated in 48 of 61 patients. The mean scores in cured patients for each of the five domains were comparable at baseline and 6 months after therapy: differences were - 0.23 to 0.13 (P > 0.20) on a scale of 1-7. The proportion of cured patients with a large decrease in quality of life (10-17% in the five domains) was similar to the proportion with a large increase (15-21%). Heartburn was present at baseline in 22 cured patients; at 6 months, it persisted in 13 and resolved in nine, whilst nine patients developed new heartburn. Conclusions: A population of patients presenting with dyspepsia should have no overall increase or decrease in quality of life due to symptomatic gastro-oesophageal reflux disease in the 6 months after H. pylori therapy.