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Eliminating Ulcer Bacteria Eases Heartburn

Longer time between episodes without H. pylori

WEDNESDAY, June 6, 2001 (HealthDayNews) -- Treating ulcer- and cancer-causing gut bacteria can delay the return of symptoms in patients with gastroesophageal reflux disease (GERD).

Swiss scientists say the use of antibiotics to suppress Helicobacter pylori can significantly lengthen the time between bouts of heartburn. Those with GERD suffer severe heartburn as a result of a leaky upper stomach backing up to the esophagus.

H. pylori, which resides in almost half the people on the planet, has been linked to both peptic ulcers and gastric tumors. Previous research had suggested that the bacteria might guard against GERD, either by reducing the volume of acidic stomach secretions or by neutralizing them through the production of ammonium, a strong base.

But the latest study, which appears in the June 2 issue of The Lancet, indicates that eradicating the bugs helps GERD patients by delaying the return of heartburn and other symptoms. The condition afflicts between 5 percent and 7 percent of people worldwide, according to the International Foundation for Functional Gastrointestinal Disorders.

Led by Dr. Werner Schwizer, a gastric disorders specialist at University Hospital in Zurich, the researchers followed 58 GERD patients, of whom 29 had active H. pylori infection. Fifteen of the subjects with the bacteria were given 10-day courses of antibiotics and 14 received dummy pills. In addition, all of the patients, including those without the bacteria, were treated for approximately nine weeks with the drug lansoprazole, a proton pump inhibitor that quells excess stomach acid.

After six months of follow-up, patients who were cleared of H. pylori or who didn't have the infection to begin with had far-longer breaks between relapses of GERD symptoms, Schwizer's group says.

Those who still had the germs stayed reflux-free for an average of 54 days, compared with 100 days for those whose germs were eradicated and 110 days for those who hadn't been infected. The differences were still significant even after controlling for the extent of acid damage to the esophagus.

"Our conclusion was that the reflux patient has a profit if you eradicated H. pylori," Schwizer says. "To make a general statement out of this small study is a little dangerous," he adds, but at least two other groups of researchers have turned up similar results in the last year. "I strongly believe it's a good thing to eradicate H. pylori; or at least, it's certainly not a disadvantage."

What To Do

If you have persistent heartburn, talk to your doctor about the best approach. It's a lot easier to treat these days.

Click here to find out more about GERD. You can also try the National Institutes of Health. For more on H. pylori, visit the Helicobacter Foundation.

Read these HealthDay stories about H. pylori.

If you're interested in seeing what clinical trials are available, take a look at Veritas Medicine.

SOURCES: Interview with Werner Schwizer, M.D., associate professor, department of gastroenterology, University Hospital, Zurich, Switzerland; June 2, 2001, The Lancet
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