Helicobacter pylori infection invariably induces chronic active gastritis which can give rise to serious consequences such as peptic ulcer and gastric malignancies. Generally accepted indications for treatment are H pylori associated peptic ulcer disease and early stages of low grade mucosa associated lymphoid tissue lymphoma of the stomach. In contrast, treatment of H pylori in patients with gastro-oesophageal reflux disease (GORD) requiring long term treatment with a proton pump inhibitor (PPI) has not yet been put on a scientific footing. In support of this indication in patients with GORD and no associated ulcer disease, the following theoretical arguments might be advanced.

In contrast, treatment of H pylori in patients with gastro-oesophageal reflux desease (GORD) requiring long term treatment with a proton pump inhibitor (PPI) has not yet been put on a scientific footing. In support of this indication in patients with GORD and no associated ulcer disease, the following theoretical arguments might be advanced.

(1)

H pylori is involved in the pathogenesis of GORD so that eradication of this organism would lead to an improvement in, or even elimination of, GORD.

(2)

Eradication of H pylori infection is associated with an improvement in the effectiveness of treatment with PPI in patients with GORD.

(3)

PPI treatment of GORD carries a higher risk in patients with H pylori infection than in H pylori negative patients, and this risk can be eliminated by eradication of the infection.