Functional dyspepsia symptom resolution after Helicobacter pylori eradication with two different regimens

Abstract

IntroductionFunctional dyspepsia (FD), a common functional gastrointestinal disorder, has a complex underlying pathophysiological mechanism that involves changes in gastric motility, visceral hypersensitivity, genetic susceptibility, psychosocial factors and Helicobacter pylori infection. Although there are several H. pylori eradication treatments, there is not enough data that compare these different eradication treatments for FD symptom resolution. Most previous studies have focused on the eradication rates of H. pylori rather than symptom relief in FD.AimIn this regard, we aimed to clarify if there is any difference between standard triple therapy and sequential therapy for symptom resolution of FD patients with H. pylori, using a validated health quality index.Material and methodsA total of 194 patients were included in this study. The patients were randomly assigned to receive standard triple therapy (omeprazole, amoxicilline and clarithromycin for 14 days) or sequential therapy (omeprazole plus amoxicilline for 7 days and omeprazole twice daily, metronidazole and clarithromycin for a subsequent 7 days) by a blind physician for H. pylori status. Outcome measures were based on symptomatic improvement at 12 months using a validated measure of subjective well-being (Gastrointestinal Symptom Rating Scale – GSRS).ResultsWe observed significant symptom resolution at 12 months in both treatment groups. On the other hand, there was no difference between the sequential or standard triple therapy groups regarding the alleviation of symptoms.ConclusionsNo difference for symptom relief exists between sequential and triple therapy in patients with FD.

Systematic review with meta-analysis: 10- or 14-day sequential therapy vs. 14-day triple therapy in the first line treatment ofHelicobacter pyloriinfection

“…A total of 27 full articles and conference abstracts were further assessed for eligibility. After exclusion of trials that used modified sequential therapy ( n = 7) and those included paediatric patients ( n = 7), a total of 13 trials including 5173 patients were eligible for inclusion in this meta‐analysis …”

“…The characteristics of the enrolled trials were shown in Table . Only the trial conducted in Latin America and the trial in Taiwan enrolled asymptomatic subjects in the community .…”

“…Besides, several other randomised trials comparing sequential therapy for either 10 or 14 days with triple therapy for 14 days have been reported after the meta‐analysis by Gatta et al . in 2013 . More importantly, none of the previous meta‐analyses included sequential therapy given for 14 days.…”

Risk of cancer in patients with irritable bowel syndrome: a nationwide population-based study

“…An example is Helicobacter pylori infection of the stomach. Numerous studies have addressed the possible pathophysiological mechanisms of functional bowel disorders, despite the unclear etiology of such disorders [14][15][16]. During the past 40 years, many factors that contribute to the pathophysiology of IBS have emerged.…”

Functional dyspepsia in adolescents: particulars of its etiology, premorbid background, and a comprehensive treatment approach

“…В Турции было проведено рандомизированное слепое контроли-руемое исследование эффективности последова-тельной (1-я группа) и стандартной (2-я группа) тройной антихеликобактерной терапии в разре-шении симптомов функциональной диспепсии. Эрадикация была достигнута у 83,54% пациен-тов из 1-й группы и у 80,4% из 2-й группы, при этом не было выявлено существенного различия в разрешении симптомов функциональной дис-пепсии [42].…”