Effect of Eradication on Functional Dyspepsia

Kim, Sung Eun; Park, Young Soo; Kim, Nayoung; Kim, Min Soo; Jo, Hyun Jin; Shin, Cheol Min; Lee, Sang Hyub; Hwang, Jung‐Won; Kim, Jin-Wook; Jeong, Sook‐Hyang; Lee, Dong Hoon; Jung, Hyun Chae

doi:10.5056/jnm.2013.19.2.233

Cited by 64 publications

(53 citation statements)

References 42 publications

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“…The genetic factors associated with FD include the genetic variant C825T in GNβ3 (Dai et al, 2014), the COX-1 gene polymorphism , polymorphism in codon 158 of the Catechol-Omethyltransferase (COMT) gene . The other potential risk factors of FD are gender, age, smoking, psychological disturbances and Helicobacter pylori (H. pylori) infection (Li et al, 2002;Shaib and El-Serag, 2004;Mahadeva and Goh, 2011;Ford, 2012;Filipovic et al, 2013;Kim et al, 2013). Furthermore, those with H. pylori infection will get chance to develop gastric cancer between three to six times more than uninfected persons (Forman et al, 1991;Nomura et al, 1991;Parsonnet et al, 1991).…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylori Infection Impacts on Functional Dyspepsia in Thailand

Piriyapong

Tangaroonsanti²,

Mahachai³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Section: Introductionmentioning

confidence: 99%

Helicobacter pylori Infection Impacts on Functional Dyspepsia in Thailand

Piriyapong

Tangaroonsanti²,

Mahachai³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…Previous reports revealed that responders at 3 months and H. pylori eradicated status were associated with improvement of dyspeptic symptoms at 1 year, regardless of the overplayed IBS. 43 Gastric mucosal inflammation induced by H. pylori infection was a crucial role in symptom generation, and the control of inflammation resulted in symptom improvement. Therefore, the Kyoto Global Consensus report insisted that H. pylori-associated dyspepsia was not as a FD, but a kind of infectious disease.…”

Section: Discussionmentioning

confidence: 99%

IsHelicobacter pyloriAssociated Functional Dyspepsia Correlated With Dysbiosis?

Kim

Chung

Kim

et al. 2017

J Neurogastroenterol Motil

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Background/AimsTo assess the long-term effect of Helicobacter pylori eradication on symptomatic improvement according to the type of antibiotic and the duration of treatment in H. pylori-associated functional dyspepsia. MethodsWe searched Pubmed, Embase, CINAHL, and the Cochrane library databases for randomized controlled trials written in English and undertaken up to August 2016 that met our eligibility criteria. The search methodology used combinations of the following keywords: Helicobacter pylori OR H. pylori OR HP; dyspepsia OR functional dyspepsia OR non-ulcer dyspepsia; eradication OR cure OR treatment. The study outcome was the summary odds ratio (OR) for symptomatic improvement in H. pylori-associated functional dyspepsia with successful eradication therapy. Subgroup analyses were performed based on the type of antibiotic, and the duration of treatment, whether or not patients had symptoms of irritable bowel syndrome, and on race. ResultsSixteen randomized controlled trials met the inclusion criteria. The summary OR for symptomatic improvement in patients in our eradication group was 1.33 (95% confidence interval [CI], 1.16-1.54; P < 0.01). In a subgroup analysis on type of antibiotic, symptomatic improvement with metronidazole-containing regimen (OR, 1.87; 95% CI, 1.26-2.77) was better than treatment with clarithromycin (OR, 1.29; 95% CI, 1.11-1.50). H. pylori eradication therapy given for 10-14 days was the more effective for symptom improvement than 7-day therapy. When the studies excluding irritable bowel syndrome cases were analyzed, there were no therapeutic effects of H. pylori eradication on symptomatic improvement. ConclusionsIn the clinical setting, the most effective H. pylori eradication regimen for functional dyspepsia to provide relief of symptoms is a metronidazole-based treatment regimen for at least 10 days. The explanation for this is that H. pylori-associated functional dyspepsia could be associated with dysbiosis.

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“…The patients' demographic and clinical data, including age, sex, history of previous H. pylori eradication treatment, and endoscopic findings, were gathered. H. pylori infection was defined by a positive rapid urease test result (CLO test; Delta West, Bentley, Australia) during a gastric mucosal biopsy procedure performed on the lesser curvature of the midantrum or midbody and/or by a positive result showing histological evidence of H. pylori with modified Giemsa staining in the gastric mucosal biopsy specimen from the lesser curvature and greater curvature of the midantrum and midbody (18).…”

Section: Methodsmentioning

confidence: 99%

“…To detect H. pylori 23S rRNA mutations related to clarithromycin resistance, H. pylori genomic DNA was extracted from the isolates (18,21). Specimens were homogenized in proteinase K solution (20 mmol/liter TrisHCl [pH 8.0], 10 mmol/liter EDTA, 0.5% sodium dodecyl sulfate, and 10 mg/ml proteinase K) by using a sterile micropestle and incubated for 3 h. DNA was isolated by phenol-chloroform extraction and ethanol precipitation.…”

Section: Methodsmentioning

confidence: 99%

High Efficacy of Finafloxacin on Helicobacter pylori Isolates at pH 5.0 Compared with That of Other Fluoroquinolones

Lee

Kim

Nam

et al. 2015

Antimicrob Agents Chemother

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Finafloxacin is a novel fluoroquinolone with improved antimicrobial efficacy, especially in an acidic environment. The efficacy of finafloxacin for the inhibition of Helicobacter pylori infection was compared with the efficacies of levofloxacin and moxifloxacin at neutral and acidic pH. The impacts of gyrA point mutation on the efficacy of those three fluoroquinolones were also investigated. A total of 128 clinical H. pylori strains were utilized. MICs of levofloxacin, moxifloxacin, and finafloxacin were determined at pH 5.0 and pH 7.0 by the agar dilution method. The impact of gyrA point mutations that are responsible for fluoroquinolone resistance was analyzed; the results showed 50 strains with an Asn-87 point mutation, 48 strains with an Asp-91 point mutation, and the remaining 30 strains with no gyrA mutations. The use of finafloxacin led to MIC values at pH 5.0 that were lower than the values seen at pH 7.0 for 112 strains (112/128, 87.5%), and this proportion was higher than that seen with moxifloxacin (21/128, 16.4%, P < 0.001). Finafloxacin also demonstrated a rate of susceptibility (MIC, <1 g/ml) (37.5%, 48/128) at pH 5.0 that was higher than that seen with moxifloxacin (2.3%, 3/128) (P < 0.001). The trends were similar regardless of which of the Asn-87, Asp-91, and A2143 point mutations were present. In conclusion, the superior antimicrobial efficacy of finafloxacin against H. pylori in an acidic environment suggests the possible use of finafloxacin for treatment of H. pylori infection, as has been proposed by its developer, Merlion Pharma. Helicobacter pylori infection is a cause of recurrent peptic ulcer disease, chronic gastritis, and gastric malignancies (1). It has been proven that the eradication of H. pylori can prevent peptic ulcer recurrence (2). However, drug instability and insufficient diffusion to gastric mucosa and mucus in that highly acidic environment require the combination of antibiotics with a proton pump inhibitor (PPI) for H. pylori eradication (3). PPI-clarithromycin-containing triple therapy was the first-line eradication treatment until recently (4). However, as the failure rate of the 7-day triple therapy has increased progressively, sequential or concomitant therapy has come to be used (3, 5). Unfortunately, the 7-day triple therapy is still regarded as the standard primary therapy in South Korea because there is no proven alternative regimen that can provide more efficient and safer eradication (6, 7). The unsatisfactory response of alternative eradication regimens was mainly caused by antimicrobial resistance and was particularly due to clarithromycin resistance (5, 8). Therefore, the Maastricht IV consensus has recommended that PPI-clarithromycin-containing triple therapy without prior susceptibility testing should be avoided when the clarithromycin resistance rate is higher than 15% to 20% (2). Moreover, the current high prevalence of metronidazole resistance in South Korea (9) indicates the necessity of reestablishment of a new standard first-line eradication therapy.In...

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Effect of Eradication on Functional Dyspepsia

Cited by 64 publications

References 42 publications

Helicobacter pylori Infection Impacts on Functional Dyspepsia in Thailand

Helicobacter pylori Infection Impacts on Functional Dyspepsia in Thailand

IsHelicobacter pyloriAssociated Functional Dyspepsia Correlated With Dysbiosis?

High Efficacy of Finafloxacin on Helicobacter pylori Isolates at pH 5.0 Compared with That of Other Fluoroquinolones

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