Editor—We read with interest the article by Harvey et al on the effects of Helicobacter pylori infection on heartburn and gastro-oesophageal reflux.1 However, as the authors recognise, the mechanism by which H pylori infection might affect reflux symptoms is by altering secretion of gastric acid, due to the H pylori related antral gastritis which results in a net increase in acid secretion.2 Nevertheless, a number of recent studies, by combining old and new diagnostic tools (such as pH monitoring, bilimetry, and intraluminal oesophageal impedance), are providing a new and more detailed characterisation of the factors contributing to the so called gastro-oesophageal reflux disease.3-5
As Harvey et al recognise, their study has some weaknesses, due to the absence of direct information on the pathology underlying the symptoms of the patients, and one of these is that a subset of the enrolled patients might have reflux symptoms due to the occurrence of non-acid or non-liquid reflux events. This may possibly lead to an underestimation of the real role of H pylori in the pathogenesis of acid-related heartburn and gastro-oesophageal acid reflux.
Competing interests: None declared.
References
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