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  1. Brendan Delaney, professor of primary care (b.c.delaney@bham.ac.uk),
  2. Paul Moayyedi, Richard Hunt-AstraZeneca professor of gastroenterology
  1. Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TT
  2. Department of Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5

    Does not increase symptoms of gastro-oesophageal reflux disease

    Does eradication of Helicobacter pylori lead to an increase in symptoms of gastro-oesophageal reflux disease? We need to know this because the benefits of eradicating H pylori relative to acid suppression alone are small in non-ulcer dyspepsia and uninvestigated dyspepsia.1 2 The absolute benefits are 6-7%, and even a small increase in gastro-oesophageal reflux disease would be likely to make eradicating H pylori in these patients of dubious benefit. New guidelines for the management of dyspepsia in Scotland and forthcoming guidelines in England and Wales recommend eradicating H pylori in both non-ulcer dyspepsia and uninvestigated dyspepsia.3 4 In addition, advocates of population screening for and treating H pylori to prevent distal gastric cancer need to ensure that the risk-benefit ratio is favourable.

    The trial reported by Harvey et al in this issue does not …

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