Does Treatment of H. Pylori Cause Acid Reflux?
At-A-Glance
- Two-thirds of the world’s population has the bacteria Helicobacter Pylori (H. pylori) in their stomachs.
- H. pylori is associated with an increased risk of stomach cancer; however, the risk is minimal, and there are many other risk factors for gastric cancer.
- Few people ever develop problems as a result of H. pylori; however, its treatment can cause or worsen acid reflux. Indeed, many people date the onset of their acid reflux to H. pylori treatment.
- If you have H. pylori, you can ignore it and not have it treated. Indeed, reflux-caused diseases (including esophageal cancer) are far more common than gastric cancer. It’s your choice.
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Heliobacterium pylori, H. pylori, is a bacteria found in the stomachs of two-thirds of the world’s population. And although H. pylori is associated with an increased risk of stomach cancer, there are many other risk factors for gastric cancer, including acid reflux, smoking, drinking, diabetes, and consumption of processed foods. Also, the risk is higher in the elderly and in Asians.
Treatment of asymptomatic H. pylori can lead to symptomatic acid reflux, and, throughout my career, I’ve never seen a single case of gastric cancer … but … I’ve had many patients report that treatment of their reflux began after treatment of their H. pylori.
When you have a colonoscopy with upper endoscopy, most GI doctors routinely test for H. pylori. If it is found, they recommend treatment with two antibiotics and PPIs, all of which can make your acid reflux worse. But if you have asymptomatic H. pylori, it can be ignored and not treated. By comparison, life-threatening reflux-caused diseases, including esophageal, throat, and lung cancer, as well as aspiration pneumonia, airway obstruction, and COPD, are much more common than gastric cancer.
To make matters even more confusing, even among gastroenterologists, there is no consensus on the symptoms of H. pylori or whether to treat asymptomatic people. Furthermore, there is no conclusive evidence that H. pylori treatment prevents gastric cancer.
Comments: (1) Only about one-third of people who develop gastric cancer have H. pylori. (2) Some antibiotics make acid reflux worse; the mechanism is unknown. (3) I recommend that gastroenterologists stop routinely screening for H. pylori and stop scaring patients into accepting “routine” treatment.
Since you probably have H. Pylori, the question is whether or not you want it treated … what should you do? If you feel fine and your GI insists on treating you anyway, you can refuse … that’s what I would do.
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