Eradication of Helicobacter Pylori
Helicobacter pylori, also called H. pylori, is a bacterium sometimes found in the mucus membranes of the stomach. It is now known to be a major cause of peptic ulcers. Antibiotics that eradicate H. pylori are an accepted treatment for curing ulcers. Of some concern, however, are studies indicating that H. pylori may actually protect against GERD by reducing stomach acid. Curing ulcers by eliminating the bacteria might trigger GERD in some people. Studies are mixed, however, on whether patients with cured H. pylori infections are at higher risk for GERD. By reducing acid production in the stomach, H. pylori may also help prevent a type of esophageal cancer called esophageal adenocarcinoma.
Still, the bacteria should be eradicated in infected patients with existing GERD who are taking acid suppressing medications. There is some evidence that the combination of H. pylori and chronic acid suppression in these patients can lead to atrophic gastritis, a precancerous condition in the stomach.
Drugs that Increase the Risk for GERD
NSAIDs. Nonsteroidal anti-inflammatory drugs (NSAIDs), common causes of peptic ulcers, may also cause GERD or increase its severity in people who already have it. There are dozens of NSAIDs, including over-the-counter aspirin, ibuprofen (Motrin, Advil, Nuprin), and naproxen (Aleve), as well as prescription anti-inflammatory medicines. People with GERD who take the occasional aspirin or other NSAID will not necessarily experience adverse effects, especially if they have no risk factors or evidence of ulcers. Acetaminophen (Tylenol), which is NOT an NSAID, is a good alternative for those who want to relieve mild pain without increasing GERD risk. Tylenol does not relieve inflammation, however.
Other Drugs. Many other drugs can cause GERD, including:
- Calcium channel blockers (used to treat high blood pressure and angina)
- Anticholinergics (used to treat urinary tract disorders, allergies, and glaucoma)
- Beta adrenergic agonists (used to treat asthma and obstructive lung diseases)
- Dopamine agonists (used in Parkinson's disease)
- Bisphosphonates (used to treat osteoporosis)
- Sedatives
- Antibiotics
- Potassium
- Iron pills
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Review Date: 07/11/2010
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor
of Medicine, Harvard Medical School; Physician, Massachusetts
General Hospital. Also reviewed by David Zieve, MD, MHA, Medical
Director, A.D.A.M., Inc.
A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)
