Relationship between <i>Helicobacter pylori</i> Eradication and Barrett’s Esophagus Elongation

Abstract

<b><i>Introduction:</i></b> <i>Helicobacter pylori</i> eradication therapy may worsen gastroesophageal reflux disease that is a significant risk factor for Barrett’s esophagus. However, the relationship between eradication therapy and Barrett’s esophagus remains controversial. This study evaluated the impact of <i>Helicobacter pylori</i> eradication on the lengthening of Barrett’s esophagus. <b><i>Materials and Methods:</i></b> We conducted a retrospective analysis of consecutive patients who successfully underwent <i>Helicobacter pylori</i> eradication between 2004 and 2017. Endoscopic images obtained before and after eradication therapy were compared for Barrett’s esophagus length according to the Prague C&amp;M criteria and the presence of reflux esophagitis based on the Los Angeles classification. <b><i>Results:</i></b> A total of 340 patients were analyzed (mean age: 66.9 ± 12.9 years) for a median follow-up of 55 months (interquartile range: 29.8–89.3). At the initial endoscopic assessment, 187 patients (55%) had a hiatal hernia, and all patients had gastric atrophy (C-0 to I: 2%, C-II to III: 47%, O-I to III: 51%). Reflux esophagitis was detected in 7 patients (2%) before eradication and in 21 patients (6%) afterward, which was a significant increase (<i>p</i> = 0.007). Barrett’s esophagus was identified in 69 patients (20%) before eradication, with a median length of C0M1. Elongation after treatment was observed in only 2 patients (0.6%). We observed no significant increase in either the prevalence (<i>p</i> = 0.85) or the median length (<i>p</i> = 0.5) of Barrett’s esophagus. <b><i>Conclusions:</i></b> Only 0.6% of patients exhibited Barrett’s esophagus lengthening after <i>Helicobacter pylori</i> eradication therapy, suggesting no significant impact of the treatment on the development or elongation of Barrett’s esophagus.