The etiology and pathogenesis of nonulcer dyspepsia (NUD) are not completely understood and consequently, no specific medication can be prescribed to the sufferers. We studied 69 cases, proved clinically, laboratorally, sonographically and endoscopically, to have NUD. Antral biopsy was taken from every case and subjected to CLO test. Out ofthe 69 patients, 51 (74%) were infected with Helicobacter pylori (HP). Oral medication, consisting of amoxacillin 500 mg, metronidazol 500 mg, and bismuth mixture, 5 mis three times daily was prescribed for four weeks. Out of the 51 patients at the end of four weeks, 46 cases (90%) were cleared of HP, and only 38 cases (74.5%) experienced complete improvement of their dyspeptic symptoms. We arrived at the conclusion that a good percentage of NUD patients can be cured by the use of the 3-drug combination.
AA Darwish, Association of Helicobacter Pylori and Nonulcer Dyspepsia. 1992; 12(1): 83-87Dyspepsia is commonly experienced as a transient unpleasant sensation in the epigastrium. Once in their lives approximately 10% of the population experience more serious and prolonged upper abdominal discomfort relating to food which is usually relieved by antacids [1]. Likewise symptoms may compel the patient to seek medical advice where a diagnosis can be made with endoscopy which may reveal an ulcer or nonulcer dyspepsia.A very interesting recent development in ulcer field has been the rediscovery of HP by Warren and Marshall in 1983 [2], in the gastric mucosa of patients suffering from gastritis. Several studies since then have been conducted to investigate the relationship between HP and peptic ulcer disease [3][4][5]. It has been found that HP causes type B chronic active gastritis [1,6]. Helicobacter pylori has also been implicated in the etiology of NUD [7,8].Helicobacter pylori is a curved gram-negative bacillus with unipolar two to six flagella that provides motility. It is found close to the gastric epithelium beneath a thin layer of mucus which separates it from the lethal acidic gastric interior. Again, it produces a protective cloud of alkali around itself, since it releases potent urease that splits gastric juice urea into one molecule of CO2 and two of ammonia with net production alkali [6]. At present, it is not known how the organism is transmitted from one person to another and no natural reservoir has been identified.We conducted this study to disclose the HP role in inducing NUD. We also studied the effect of a combination of drug treatment for this condition.
Material and MethodsThis study was conducted in King Fahad Hofuf Hospital between May and July, 1990. It comprised 69 patients suffering from dyspepsia and referred to esophagogastroduodenoscopy (ECD) from surgical and medical outpatient clinics. Patients were not included in the study if they were taking steroids, nonsteroid anti-inflammatory drugs, antibiotics, H2 blockers or antacids. A physical examination was performed on every patient. Laboratory studies included routine blood chemistry, liver enzymes and ...