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Objectives: To ascertain the prevalence of Helicobacter pylori in patients with gastro-oesophageal reflux disease and its association with the disease.

Design: Systematic review of studies reporting the prevalence of H pylori in patients with and without gastro-oesophageal reflux disease.

Data sources: Four electronic databases, searched to November 2001, experts, pharmaceutical companies, and journals.

Main outcome measure: Odds ratio for prevalence of H pylori in patients with gastro-oesophageal reflux disease.

Results: 20 studies were included. The pooled estimate of the odds ratio for prevalence of H pylori was 0.60 (95% confidence interval 0.47 to 0.78), indicating a lower prevalence in patients with gastro-oesophageal reflux disease. Substantial heterogeneity was observed between studies. Location seemed to be an important factor, with a much lower prevalence of H pylori in patients with gastro …