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Helicobacter Pylori and Reflux Disease

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Barrett’s Esophagus

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Abstract

The presence of spiral bacteria on the human gastric mucosa was already described more than one hundred years ago.1 Nevertheless, the clinical importance of this observation only appeared after Warren and Marshall were able to culture bacteria from gastric biopsy samples in 1982.2 Initially, this bacterium was named Campylobacter pyloridis but, after further identification of its biochemical properties the new genus Helicobacter was introduced and the bacterium was renamed Helicobacter pylori (H. pylori).3 It appeared that half of the world’s population is colonized with this bacterium, which colonization usually persists lifelong and remains asymptomatic in the majority of cases. However, H. pylori colonization is virtually always accompanied by chronic active gastritis, which increases the individual’s risk for the development of several gastroduodenal diseases, such as gastric and duodenal ulceration, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and distal gastric cancer, making it a pathogen of great significance. In particular, it is estimated that approximately 10–20% of H pylori-positive subjects ultimately develops ulcer disease, whereas 1–2% develops adenocarcinoma of the distal stomach. The chances of developing these complications depend upon the genetics and acid output of the host, external factors such as diet, and the characteristics of the bacterial strain. For instance, the chance of developing gastric cancer as a result of H. pylori colonization is increased in subjects with the IL-1 haplotype encoding for the most pronounced IL-1 (response to colonization,4 as well as in those with a high-salt intake, or colonized with more virulent strains. All of these factors are associated with more severely active chronic gastritis and thus increase the risk for permanent mucosal damage with atrophy and intestinal metaplasia.

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  1. A. Cats
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  1. Erasmus University Medical Centre, Rotterdam, The Netherlands

    Hugo W. Tilanus (Professor of Surgery) (Professor of Surgery)

  2. Hope Hospital, Salford, UK

    Stephen E. A. Attwood F.R.C.S. (Consultant Surgeon) (Consultant Surgeon)

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Cats, A., Kuipers, E.J. (2001). Helicobacter Pylori and Reflux Disease. In: Tilanus, H.W., Attwood, S.E.A. (eds) Barrett’s Esophagus. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-0829-6_7

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