Therapy for <i>Helicobacter pylori</i> in Patients with Nonulcer Dyspepsia

Laine, Loren; Schoenfeld, Philip; Mb, Fennerty

doi:10.7326/0003-4819-134-5-200103060-00008

Cited by 230 publications

(156 citation statements)

References 20 publications

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“…Many studies have shown good symptomatic response after anti-H. pylori treatment in patients with functional dyspepsia 12-14 whereas others have not observed a positive effect of anti-H. pylori treatment on symptoms of functional dyspepsia. [15][16][17] The results of the present study are in favour of an aetiological role of H. pylori in patients with functional dyspepsia. H. pylori was found in 65% of the patients with functional dyspepsia.…”

Section: Discussionmentioning

confidence: 50%

Role of helicobacter pylori in functional dyspepsia

Shrivastava¹,

Gupta²,

Gupta³

et al. 2006

Endoscopy

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Background: The association of Helicobacter pylori with functional dyspepsia is widely reported, but it remains unclear whether H. pylori infection actually causes symptoms or is just an associated finding. Aims: This study was conducted to determine the role of H. pylori in causing symptoms of functional dyspepsia and to observe any improvement in symptoms after eradication of H. pylori. Setting and Design: This study was conducted in a prospective, randomised double-blind manner at the Surgery Department of our institution. Materials and Methods: Eighty patients with functional dyspepsia were randomly distributed into two groups to receive eradication or placebo therapy after taking biopsies for H. pylori. Symptom evaluation was done at baseline, at one and at three months to notice any improvement. Statistical Analysis: Changes in the dyspepsia score were compared using ANOVA test at baseline, one and at three months to compare the improvement in symptoms.Results: Approximately two-thirds of patients with functional dyspepsia are infected with H. pylori. Significant longterm improvement was observed after eradication in H. pylori infected patients. No significant improvement was seen with placebo therapy. Conclusion: H. pylori plays a significant role in causing symptoms of functional dyspepsia. Treatment with triple drug regimen brings a significant long-term improvement in the symptoms.

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Section: Discussionmentioning

confidence: 50%

Role of helicobacter pylori in functional dyspepsia

Shrivastava¹,

Gupta²,

Gupta³

et al. 2006

Endoscopy

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“…While eradication of Helicobacter pylori has been advocated for the treatment of patients with functional dyspepsia, the results of such eradication studies have been generally disappointing and any long-term benefit is debatable. 10 Finding convincingly effective treatment options thus continues to be an important goal.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six‐week placebo‐controlled, double‐blind, multicentre trial

Holtmann

Adam

Haag

et al. 2003

Aliment Pharmacol Ther

126

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SUMMARYBackground: This study aimed to assess the efficacy of artichoke leaf extract (ALE) in the treatment of patients with functional dyspepsia (FD). Methods: In a double-blind, randomized controlled trial (RCT), 247 patients with functional dyspepsia were recruited and treated with either a commercial ALE preparation (2 · 320 mg plant extract t.d.s.) or a placebo. The primary efficacy variable was the sum score of the patient's weekly rating of the overall change in dyspeptic symptoms (four-point scale). Secondary variables were the scores of each dyspeptic symptom and the quality of life (QOL) as assessed by the Nepean Dyspepsia Index (NDI).

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“…severe inflammation and more significant gastroduodenal pathologies but not with symptom severity or clinical outcome (2,3,6,8).…”

Section: Discussionmentioning

confidence: 99%

“…The role of H. pylori testing and treatment in patient management is a major component of all of these guidelines, although recently published data do not support the view that treatment of H. pylori has a beneficial effect on symptoms and quality of life (2). However, some studies have revealed the beneficial effect of treatment for H. pylori eradication in some dyspepsia subgroups (10).…”

Section: Introductionmentioning

confidence: 99%

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Functional dyspepsia: relationship between clinical subgroups and Helicobacter pylori status in Western Turkey

Saruç

Ozden

Türkel

et al. 2003

Braz J Med Biol Res

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The etiology of functional dyspepsia is not known. The objective of the present study was to determine the characteristics of functional dyspepsia in Western Turkey. We divided 900 patients with functional dyspepsia into three subgroups according to symptoms: ulcer-like (UL), 321 (35.6%), motility disorder-like (ML), 281 (31.2%), and the combination (C) of these symptoms, 298 (33.1%). All patients were submitted to endoscopic evaluation, with two biopsies taken from the cardia and corpus, and four from the antrum of the stomach. All biopsy samples were studied for Helicobacter pylori (Hp) density, chronic inflammation, activity, intestinal metaplasia, atrophy, and the presence of lymphoid aggregates by histological examination. One antral biopsy was used for the rapid urease test. Tissue cagA status was determined by PCR from an antral biopsy specimen by a random sampling method. We also determined the serum levels of tumor necrosis factor-α (TNF-α) and gastrin by the same method. Data were analyzed statistically by the Kolmogorov-Smirnov test and by analysis of variance. Hp and cagA positivity was significantly higher in the UL subgroup than in the others. The patients in the ML subgroup had the lowest Hp and cagA positivity and Hp density. The ML subgroup also showed the lowest level of Hp-induced inflammation among all subgroups. The serum levels of TNF-α and gastrin did not reveal any difference between groups. Our findings show a poor association of Hp with the ML subgroup of functional dyspepsia, but a stronger association with the UL and C subgroups.

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Therapy for Helicobacter pylori in Patients with Nonulcer Dyspepsia

Abstract: This meta-analysis provides little support for the use of H. pylori eradication therapy in patients with nonulcer dyspepsia.

Cited by 230 publications

References 20 publications

Role of helicobacter pylori in functional dyspepsia

Role of helicobacter pylori in functional dyspepsia

Efficacy of artichoke leaf extract in the treatment of patients with functional dyspepsia: a six‐week placebo‐controlled, double‐blind, multicentre trial

Functional dyspepsia: relationship between clinical subgroups and Helicobacter pylori status in Western Turkey

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