Increased Reflux Esophagitis after Helicobacter pylori Eradication Therapy in Cases Undergoing Endoscopic Submucosal Dissection for Early Gastric Cancer

SIMPLE SUMMARY: Helicobacter pylori infection is associated with the development of gastric cancer. Reflux esophagitis may occur in the postoperative period of patients undergoing surgical therapy for gastric cancer. The role of eradication therapy of Helicobacter pylori in reflux esophagitis is controversial. Here, we evaluated the occurrence of reflux esophagitis before and after Helicobacter pylori eradication in patients having endoscopic submucosal resection for early gastric cancer. Reflux esophagitis before and after eradication therapy was evaluated during the follow-up. While reflux esophagitis incidence increased from 3.1% to 18.8% in the successful eradication group, no case of reflux esophagitis was observed in the failed eradication group. There was a significant correlation between successful Helicobacter pylori eradication rate and reflux esophagitis development. This study demonstrates that a successful Helicobacter pylori eradication therapy is a risk factor for newly developed reflux esophagitis in patients having endoscopic submucosal dissection for early gastric cancer. ABSTRACT: Background: The role of Helicobacter pylori in the pathogenesis of reflux esophagitis is controversial. This study investigated the frequency of reflux esophagitis before and after H. pylori eradication in patients having endoscopic submucosal dissection for early gastric cancer. Methods: This study included 160 patients that fulfilled the study’s criteria. Endoscopy was performed before and after H. pylori eradication, and reflux esophagitis was evaluated during the follow-up period. Results: Seropositivity for H. pylori in patients with early gastric cancer was 68.8%, 101 of them received eradication therapy. During the follow-up period, the incidence of reflux esophagitis increased from 3.1% to 18.8% in the successful eradication group but no case of reflux esophagitis was observed in the failed eradication group. The univariate and multivariate analyses showed a significant correlation between successful H. pylori eradication rate and the development of reflux esophagitis. Conclusions: This study demonstrated that a successful H. pylori eradication therapy is a risk factor for newly developed reflux esophagitis in patients with endoscopic submucosal dissection for early gastric cancer.