Helicobacter pyloriInfection in Gastroesophageal Reflux Disease in the Asian Countries

Abstract

Helicobacter pyloriinfection, a common infection in many countries, is related to the clinical course of upper gastrointestinal diseases. Gastroesophageal reflux disease (GERD) is a common esophageal disease in Western countries and its prevalence is increasing in Asian countries. The pathophysiology of GERD is multifactorial. Although no single factor has been isolated as the cause of GERD, a negative association between the prevalence ofH. pyloriand the severity of GERD, including Barrett’s esophagus, has been demonstrated in epidemiological studies. The high prevalence ofH. pyloriinfection affects the incidence of GERD in Asian countries. In the subjects with East Asian CagA-positive strains, acid injury may be minimized by hypochlorhydria from pangastritis and gastric atrophy. Additionally, host genetic factors may affect the development of GERD. The interactions between genetic factors and the virulence ofH. pyloriinfection may be the reason for the low prevalence of GERD in Asian countries.H. pylorieradication is not considered pivotal in GERD exacerbation based on evidence from Western studies. A recent meta-analysis demonstrated that eradication therapy ofH. pyloriwas related to a higher risk of developingde novoGERD in Asian studies.H. pyloriinfection remains an inconclusive and important issue in GERD in Asian countries.