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Background: Reflux esophagitis (RE) and absence of Helicobacter pylori (non-H. pylori) are considered to be associated with the progression to long-segment Barrett’s esophagus (LSBE). However, it is difficult to assess this association because RE and H. pylori status can change during follow-up. Additionally, the association between H. pylori eradication and LSBE remains unclear.
Methods: A total of 11,493 asymptomatic Japanese subjects who underwent medical check-ups and were endoscopically diagnosed with short-segment Barrett’s esophagus (SSBE) between May 2006 and December 2015 were enrolled. The hazards of progression to LSBE were compared between time-varying RE and H. pylori infection/eradication by time-dependent multivariable Cox proportional hazards models.
Results: A total of 7,637 subjects who underwent additional medical check-ups after being diagnosed with endoscopic SSBE were analyzed. Subjects with RE and without current/past H. pylori infection were strongly associated with a higher rate of progression to LSBE (adjusted hazard ratio [HR]: 7.17, 95% confidence interval [CI]: 2.48-20.73, p<0.001 for RE and non-H. pylori vs. non-RE and H. pylori groups). Subjects with H. pylori had a lower rate of progression to LSBE (adjusted HR: 0.48, 95% CI: 0.22-1.07, p=0.07 for H. pylori vs. non-H. pylori). Hazards of progression to LSBE were still lower in the H. pylori eradication group than that of the non-H. pylori group (adjusted HR: 0.51, 95% CI: 0.18-1.46, p=0.21).
Conclusions: RE and non-H. pylori were associated with the progression to LSBE, considering the changes in exposures. H. pylori infection was associated with the prevention of the development of LSBE irrespective of RE. The environment preventive of the development of LSBE persists for at least a few years after H. pylori eradication.
Keywords
Helicobacter pylori, eradication, reflux esophagitis, Barrett’s esophagus, SSBE, LSBE, endoscopy, elongation, time-dependent, time-varying
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CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
Version 3
Posted 12 Aug, 2020
No community comments so far
Submission checks complete
On 07 Aug, 2020
Editorial decision: Accept
On 07 Aug, 2020
No comments provided
Reviewer #1 agreed
On 23 Jul, 2020
Review #1 received
Received 23 Jul, 2020
Editor assigned
On 22 Jul, 2020
Reviewers invited
Invitations sent on 22 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
No comments provided
Editorial decision: Major revision
On 22 Jun, 2020
Review #3 received
Received 18 Jun, 2020
Reviewer #3 agreed
On 17 Jun, 2020
Review #2 received
Received 23 May, 2020
Reviewer #2 agreed
On 19 May, 2020
Review #1 received
Received 06 May, 2020
Reviewer #1 agreed
On 02 May, 2020
Reviewers invited
Invitations sent on 01 May, 2020
Submission checks complete
On 16 Apr, 2020
Editor invited
On 16 Apr, 2020
Editor assigned
On 13 Apr, 2020
First submitted
On 09 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
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Subject Areas
Gastroenterology & Hepatology
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A new preprint design is coming!
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See the published version of this preprint at BMC Gastroenterology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
Version 3
Posted 12 Aug, 2020
No community comments so far
Submission checks complete
On 07 Aug, 2020
Editorial decision: Accept
On 07 Aug, 2020
No comments provided
Reviewer #1 agreed
On 23 Jul, 2020
Review #1 received
Received 23 Jul, 2020
Editor assigned
On 22 Jul, 2020
Reviewers invited
Invitations sent on 22 Jul, 2020
Submission checks complete
On 21 Jul, 2020
Editor invited
On 21 Jul, 2020
No comments provided
Editorial decision: Major revision
On 22 Jun, 2020
Review #3 received
Received 18 Jun, 2020
Reviewer #3 agreed
On 17 Jun, 2020
Review #2 received
Received 23 May, 2020
Reviewer #2 agreed
On 19 May, 2020
Review #1 received
Received 06 May, 2020
Reviewer #1 agreed
On 02 May, 2020
Reviewers invited
Invitations sent on 01 May, 2020
Submission checks complete
On 16 Apr, 2020
Editor invited
On 16 Apr, 2020
Editor assigned
On 13 Apr, 2020
First submitted
On 09 Apr, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Gastroenterology & Hepatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Gastroenterology.
Background: Reflux esophagitis (RE) and absence of Helicobacter pylori (non-H. pylori) are considered to be associated with the progression to long-segment Barrett’s esophagus (LSBE). However, it is difficult to assess this association because RE and H. pylori status can change during follow-up. Additionally, the association between H. pylori eradication and LSBE remains unclear.
Methods: A total of 11,493 asymptomatic Japanese subjects who underwent medical check-ups and were endoscopically diagnosed with short-segment Barrett’s esophagus (SSBE) between May 2006 and December 2015 were enrolled. The hazards of progression to LSBE were compared between time-varying RE and H. pylori infection/eradication by time-dependent multivariable Cox proportional hazards models.
Results: A total of 7,637 subjects who underwent additional medical check-ups after being diagnosed with endoscopic SSBE were analyzed. Subjects with RE and without current/past H. pylori infection were strongly associated with a higher rate of progression to LSBE (adjusted hazard ratio [HR]: 7.17, 95% confidence interval [CI]: 2.48-20.73, p<0.001 for RE and non-H. pylori vs. non-RE and H. pylori groups). Subjects with H. pylori had a lower rate of progression to LSBE (adjusted HR: 0.48, 95% CI: 0.22-1.07, p=0.07 for H. pylori vs. non-H. pylori). Hazards of progression to LSBE were still lower in the H. pylori eradication group than that of the non-H. pylori group (adjusted HR: 0.51, 95% CI: 0.18-1.46, p=0.21).
Conclusions: RE and non-H. pylori were associated with the progression to LSBE, considering the changes in exposures. H. pylori infection was associated with the prevention of the development of LSBE irrespective of RE. The environment preventive of the development of LSBE persists for at least a few years after H. pylori eradication.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
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