This meta-analysis investigated whether eradication of Helicobacter pylori (Hp) infection is associated with the development of new gastro-oesophageal reflux disease (GORD) in patients who had no evidence of GORD at entry.

A literature search was carried out for RCTs and cohort studies (1983 to 2007) involving patients with Hp infection and with no evidence of GORD assigned into at least two groups, receiving either Hp eradication therapy or placebo. Twelve studies were identified (7 RCTs and 5 cohorts) and the following findings were reported:

• In 6 RCTs using erosive GORD as outcome, the odds ratio (OR) for the frequency of GORD in Hp eradicated group vs. persistent Hp group was 1.11 (0.81 to 1.53, p = 0.52)

• In 5 RCTs using symptomatic outcome, the OR for the frequency of GORD in Hp eradicated group vs. persistent Hp was 1.22 (0.89 to 1.69, p = 0.22).

• In cohort studies, the OR for the frequency of GORD in Hp eradicated group vs. persistent Hp was 1.37 (0.89 to 2.12; p = 0.15).

• Test of heterogeneity was not significant for any analyses.

• The results were consistent in subgroup and sensitivity analyses, including cohort studies vs. RCTs, high-quality studies vs. low-quality studies, and use of endoscopic vs. symptomatic outcomes except for the subgroup of patients with peptic ulcer disease (PUD) in cohort studies (OR: 2.04; 1.08 to 3.85; p = 0.03).

It was concluded “there is no association between Hp eradication and development of new cases of GORD in the population of dyspeptic patients. However, in cohort studies, there seems to be a twofold higher risk of development of erosive GORD in patients with PUD. The effect in RCTs of patients with PUD did not show a significant difference.”