Helicobacter pylori感染と逆流性食道炎

Helicobacter Infection and Reflux Esophagitis

要旨　H. pylori（Helicobacter pylori）感染は胃炎や消化性潰瘍，胃癌などの疾患の重要な病原因子である．H. pylori感染と逆流性食道炎の関係については，地域別にその関係をみた報告では，東アジアでは逆流性食道炎のH. pylori感染率が対照群と比べ低く，西ヨーロッパや北アメリカでは関連がないとする報告が多い．日本では，H. pylori感染は胃粘膜萎縮を起こすことが多く，胃酸分泌が低下するため，H. pylori感染者では逆流性食道炎が発生しにくい可能性がある．一方，H. pylori除菌後の逆流性食道炎の発生については，除菌により逆流性食道炎の発生は認めるものの，頻度は高いものではなく，また軽症のものが多く，除菌療法の妨げとはならない．

　H. pylori（Helicobacter pylori）is an important pathogen that is known to be associated with gastritis, peptic ulcer diseases, and gastric cancer. Although the association between H. pylori infection and reflux esophagitis is uncertain, recent study indicates that the prevalence of H. pylori in East Asia is significantly lower in patients with reflux esophagitis than in controls, and that no significant difference is found from Western Europe and North America. The prevalence of reflux esophagitis is low in H. pylori-infected subjects in Japan because of the hypochlorhydria induced by H. pylori-induced atrophic gastritis. Although the prevalence of reflux esophagitis may increase after H. pylori eradication, the development of esophagitis is not a serious hindrance in the treatment of H. pylori eradication.