Med Bull Sisli Etfal Hosp. 2022; 56(3): 408-413 | DOI: 10.14744/SEMB.2022.55476

Relationship Among Helicobacter Pylori, Lower Esophagus Sphincter Pressure, and Gastroesophageal Reflux: A Single-Center Experience

Ferhat Bacaksiz¹, Omer Ozturk², Ilyas Tenlik², Berat Ebik¹, Derya Ari², Volkan Gokbulut², Ozlem Akdogan², Yasemin Ozin², Zeki Kilic², Ertugrul Kayacetin^2
1Department of Gastroenterology, University of Health Sciences Türkiye, Diyarbakýr Gazi Yaþargil Research and Training Hospital, Diyarbakýr, Türkiye
²Department of Gastroenterology, Ankara City Hospital, Ankara, Türkiye

Objectives: The aim of the study was to evaluate the relationship among lower esophageal sphincter pressure (LESP), Helicobacter pylori (Hp), and gastroesophageal reflux (GER).
Methods: The retrospective study included patients with isolated hypertensive or hypotensive lower esophageal sphincter (LES) who underwent esophageal manometry in our gastroenterology motility laboratory and had normal manometry results. Demographic characteristics, complaints on admission, upper endoscopy findings, 24-h esophageal pH monitoring results, and presence of Hp in gastric biopsy were evaluated.
Results: A total of 1226 patients were included in the study, among whom women comprised 54% of all patients. Mean age was 45.4±13.4 years. Most common presenting complaint was pyrosis (85.4%). Pathological reflux was detected in 61.4% of the patients in 24-h esophageal pH monitoring. Reflux esophagitis was detected in 22.9% and LES laxity was present in 17.4% of the patients. In gastric biopsy, Hp was positive in 40% of the patients. The age of patients with hypertensive LES was significantly higher and female gender and body mass index (BMI) were associated with hypertensive LES. Pyrosis was significantly less prevalent in patients with hypertensive LESP. Esophagitis and LES laxity were significantly more prevalent in patients with hypotensive LES. No significant difference was found among the three groups with regard to reflux and Hp positivity. No significant difference was found between Hp-positive and Hp-negative groups with regard to reflux and reflux esophagitis.
Conclusion: No clear relationship was found among LES disorders, GER, and Hp. Moreover, no significant difference was found among LES disorders with regard to GER, while the presence of hypotensive LESP, rather than Hp, was found to be an important factor in the development of reflux esophagitis.

Keywords: Gastroesophageal reflux, Helicobacter pylori, Hypertensive lower esophageal sphincter, Hypotensive lower esophageal sphincter

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H. pylori, alt özöfagus sfincter basinci ve gastroözofageal reflü arasindaki iliþki: Tek merkez deneyimi

Ferhat Bacaksiz¹, Omer Ozturk², Ilyas Tenlik², Berat Ebik¹, Derya Ari², Volkan Gokbulut², Ozlem Akdogan², Yasemin Ozin², Zeki Kilic², Ertugrul Kayacetin^2
1SBU Diyarbakýr Gazi Yaþargil Eðitim ve Araþtýrma Hastanesi, Gastroenteroloji Anabilim Dalý, Diyarbakýr
²Ankara Þehir Hastanesi, Gastroenteroloji Bölümü, Ankara

Amaç: Alt özofagus sfinkter basýncýnýn 24 saatlik ph metre testi ve H. pylori ile olan iliþkisini deðerlendirmeyi amaçladýk.
Gereç ve yöntemler: Özofagus manometri testi normal olan ve manometride izole hipotansif ve izole hipertansif alt özofagus sfinkteri tespit edilen hastalarýn verileri retrospektif olarak tarandý. Hastalarýn demografik özellikleri, baþvuru þikâyetleri, üst endoskopi bulgularý, 24 saatlik pH metre sonuçlarý ve mide biyopsi örneklerinde H. pylori varlýðý deðerlendirildi.
Bulgular: Çalýþmaya toplam 1226 hasta alýndý. Tüm hastalarýn %54’ü kadýndý. Ortalama hasta yaþý 45.4±13.4’tü. Hastalar en sýk pirozis (%85.4) þikayeti ile baþvurmuþtu. %61.4’ünde patolojik reflü saptandý. Hastalarýn %22.9’unda reflü özofajit vardý. Hastalarýn %40 kadarýnda H.pylori pozitif saptandý. Hipertansif LESB olan hastalarýn yaþý istatistiksel olarak anlamlý þekilde yüksekti ve Hipertansif LESB anlamlý oranda kadýnlarda daha fazlaydý. Pirozis, Hipertansif LESB olan hastalarda, anlamlý oranda daha az görülen þikayetti. BMÝ, Hipertansif LESB olanlarda istatistiksel olarak anlamlý oranda daha yüksekti. Özofajit ve LES Gevþekliði istatistiksel olarak anlamlý oranda Hipotansif LES olan hastalarda daha çok saptandý. Gruplar arasýnda reflü ve H.pylori pozitifliði açýsýndan istatistiksel olarak anlamlý fark saptanmadý. H. pylori pozitif ve negatif olan hastalar karþýlaþtýrýldýðýnda, reflü ve reflü özofajit açýsýndan anlamlý farklýlýk saptanmadý.
Sonuç: Özofagus manometrisinde LES basýncýnýn normal, hipotansif veya hipertansif olmasý ile, gastroözofageal reflü ve H. pylori arasýnda net bir iliþki saptanmadý. LES basýnçlarý arasýnda, 24 saatlik pH metrede farklýlýk görülmese de reflü özofajit geliþiminde, H. pylori’ den ziyade hipotansif LES varlýðý önemli görünmektedir. (SETB-2021-12-382)

Anahtar Kelimeler: Hipotansif Alt Özofagus Sfinkteri, Hipertansif Alt Özofagus Sfinkteri, H. pylori, Gastroözofageal Reflü

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