ALIMENTARY TRACT DIGEST LIVER OIS 2002;34:328-31 Influence of Helicobacter pylori infection on severity of oesophagitis and response to therapy in the elderly A. Pilotto M. Franceschi G. Leandrol M. Rassu2 L. Bozzola3 G. Valerio F. Di Mario4 Digestive Pathophysiolagy Cantre, Geriatric Division, “Sen Bortolo” Hospital, Vicenza; I Gastroenterology Division, IRCCS, Castellana GmUe, Bari; * Micmbiology Service; 3 Clinical Pschology Service, “San Eortolo” Hospital, Vicenza; 4 Chair of Gastmentemlogy, University of Parma, /m/y, Mh lor cwTee~e Dr. A. Pilofto, Fisiopacologia Digestiva dell’Anzieno, LJnitri Operativa Gerialtria, Ospedale “San Bortolo”, via Rodolfi 37, 36100 Vicenza, I&iy. Fax: +39-0444-993596. E-mail: alberto. piloiXo@libam.it Submitted September 18, 2007. Accepted after revision, January 9, 2002 Background. The prevalence both of Helicobacter pylori infection and oesophagitis is higher in the elderly than in adult and young popula- tions. Howevel: the relationship between Helicobacter pylori infection and the clinical behaviour of oesophagitis has not yet been clarified. Aim. To evaluate the influence of Helicobacter pylori infection on the severity and clinical outcome after treatment of oesophagitis in elder- ly patients. Methods. A total of 271 elderly patients [I34 male, 137 female, mean age = 79.2 years, range 65-961 with grade I to 3 oesophagitis were studied. At baseline, the patients were divided into 3 groups ac- cording to Helicobacter pylori infection: Group 1 = 88 Helicobacter py- lori-negative patients; Group 2 = 59 Helicobacter pylori-positive pa- tients and Group 3 = 124 Helicobacter pylori-positive patients who un- derwent a one-week proton pump inhibitor-based triple therapy for the eradication of Helicobacter pylori infection. A// patients were treated with proton pump inhibitors for two months; patients in Group 3 were also treated for one week with proton pump inhibitors plus two antibi- otics. After two months, endoscopy and histology were repeated. Results. At baseline, 32.5% of patients were Helicobacter pylori-neg- ative and 67.5% were Helicobacter pylori-positive. No baseline differ- ences in severity of oesophagitis were found between Helicobacter py- lori negative and positive patients. After proton pump inhibitor therapy, the complete resolution of oesophagitis was observed in 80.7% of Group 1, 76.3% of Group 2 and 75.8% of Group 3 [p=ns). Dividing pa- tients also according to the severity of oesophagitis, no difference in healing rates between the three Groups were observed. Conclusions. In this elderly population, Helicobacter pylori infection did not influence the severity of oesophagitis at baseline or the response to short-term treatment with proton pump inhibitors. Furthermore, Helicobacter pylori eradication therapy did not influence the healing rate of oesophagitis. Digest Liver Dis 2002;34:328-31 Key words: elderly; Helicobacter py/ori; oesophagitis; proton pump inhibitors Introduction The prevalence both of Helicobacter pylori (H. pylori) infection and oe- sophagitis is higher in the elderly, than in adult and young populations. However, the relationship between H. pylori infection and the clinical be- haviour of oesophagitis has not yet been clarified ‘, particularly in old age. A study carried out in elderly patients failed to find any significant associ- ation between the presenceof H. pylori and reflux oesophagitis *. More re- cently, a significantly lower prevalence of H. pylori infection was found in reflux oesophagitis patients over 60 years of age in comparison with sex- and age-matched controls ‘. 328 -__11~~