Between Scylla and Charybdis: The Relationship of Gastroesophageal Reflux Disease and H. Pylori

Between Scylla and Charybdis: The Relationship of Gastroesophageal Reflux Disease and H. Pylori

As physicians navigate the waters of upper gastrointestinal acid peptic disorders, they are faced with the two most common upper gastrointestinal disorders of Gastroesophageal Reflux Disease (GERD) and Helicobacter pylori (H. pylori). As Scylla and Charybdis they present serious problems that can range from inflammation and ulceration to malignancy. As the prevalence of H. pylori and its associated diseases have declined in the Westernized countries of the world, the incidence of GERD and its complications have increased, suggesting an inverse relationship between the two disease states. There appears to be a worldwide evolution of upper digestive diseases from H. pylori and its related diseases to GERD and its related diseases that alters the type of acid related disorder and malignancies of the upper digestive tract confronting the physician.