Association between infection of Helicobacter pylori and the risk of reflux oesophagitis occurrence or recurrence: a systematic review and meta-analysis.

Background: To investigate the correlation between infection of Helicobacter pylori (H. pylori) and the risk of reflux oesophagitis (RE) occurrence or recurrence.

Methods: Literature was retrieved from PubMed, Embase, Web of Science and Cochrane Library databases, and the search period ranged from the time of database establishment to December 2024. Prospective cohort studies and randomised controlled trials were included for data analysis to assess the association of infection of H. pylori with the risk of RE occurrence and recurrence, and subgroup analyses were performed.

Results: The overall risk of RE in the H. pylori-eradicated group was significantly higher than that in the placebo group (p<0.01). The analysis failed to detect a statistically significant difference in RE risk between the H. pylori-eradicated group and placebo group among different age groups, regions and disease types. The risk of RE significantly increased after eradication of H. pylori for >1 year (p<0.01).

Conclusion: Infection of H. pylori in different age groups, regions and diseases may lead to the occurrence or recurrence of RE after receiving H. pylori eradication treatment. This correlation increased as the follow-up period extended. Although receiving H. pylori eradication treatment may increase the risk of RE occurrence or recurrence, doctors should take into consideration the individual situation of the patient to determine whether eradication treatment should be administered concomitantly or postponed during clinical treatment decision making.

Prospero registration number: CRD 42024529321.