New Research May Help GERD Patients Prevent Progression of Barrett's Esophagus

New research has found that patients with GERD who use proton pump inhibitors may be able to prevent the progression of gastric intestinal metaplasia (Barrett's esophagus) by eliminating a bacterium from the body.

Dr. Bor-Shyang Sheu of the National Cheng Kung University Medical Center in Tainan, Taiwan, and fellow researchers have found that, in patients with GERD who use long-term esomeprazole, the elimination of Helicobacter pylori (H. pylori) led to a dramatic decrease in gastritis. Patients positive for H. pylori who did not undergo eradication treatment had gastritis that persisted. Gastric atrophy “declined significantly” for patients who had undergone the eradication treatment in the first and second year after treatment, the researchers noted, and “the prevalence of gastric atrophy” was significantly less in the eradication patients’ second year after treatment. In addition, patients who had undergone the eradication treatment “had more regression and less development of gastric atrophy and intestinal metaplasia” than the untreated patients did.

According to an abstract on the study that appeared in The American Journal of Gastroenterology, the research team enrolled 325 reflux esophagitis patients in the study and divided them into three groups: “(i) the H. pylori—positive eradication group receiving 1-week triple therapy (n=105); (ii) H. pylori—positive non-eradication controls (n=105); and (iii) H. pylori—negative controls (n=115).” The journal article also noted that all study participants “received continuous esomeprazole until sustained symptomatic response, and when possible, shifted to on-demand therapy (ODT) thereafter.”

The researchers concluded that, according to the abstract, “in patients using long-term esomeprazole for reflux esophagitis, screening for and eradicating H. pylori infection are necessary in order to limit the progression or cause the regression of gastric precancerous changes.”

"Treatment of H. pylori will prevent ulcer relapse, new ulcers, and, possibly, newly developed precancerous change, progression of pre-existing precancerous changes, or even reverse precancerous changes," Dr. Sheu added. "Therefore, it may be possible to decrease the rate of gastric cancer."