Helicobacter pylori and gastro-oesophageal reflux disease: Important data were not presented

doi:10.1136/bmj.329.7462.402-a

BMJ 2004;329:402 (14 August), doi:10.1136/bmj.329.7462.402-a

Letter

Helicobacter pylori and gastro-oesophageal reflux disease

Important data were not presented

The first 150 words of the full text of this article appear below.

EDITOR—The paper by Harvey at al shows several inconsistencies.¹The first line contains an error: most patients with Helicobacterpylori actually have a mild pangastritis with normal or decreasedintragastric acidity; the antral inflammation stimulates hypergastrinaemiabut is balanced by a relative suppression of acid secretionby the oxyntic body, and duodenal ulcer occurs in only 10% ofinfected patients.²

The authors seem confused as to whether they are assessing gastrooesophagealreflux disease, as claimed, or occasional symptoms. The prevalenceof symptoms once a month, the authors' definition, is very highand may not be pathological. Authorities propose that heartburntwice a week is a more reasonable definition of reflux disease.³

If the study was designed to address the question of H pyloriand reflux the structure is suboptimal. Well validated questionnairesdesigned specifically for reflux symptoms are available.⁴ Refluxis more severe in elderly people,^4
5 and by . . . [Full text of this article]

Ian L P Beales, senior lecturer

Norfolk and Norwich University Hospital NHS Trust, Norwich NR4 7TJ ian.beales@uea.ac.uk

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