Clinical trial: prolonged beneficial effect of Helicobacter pylori eradication on dyspepsia consultations - the Bristol Helicobacter Project.

Abstract

BACKGROUND:

Chronic infection of the stomach with Helicobacter pylori is widespread throughout the world and is the major cause of peptic ulcer disease and gastric cancer. Short-term benefit results from community programmes to eradicate the infection, but there is little information on cumulative long-term benefit.

AIM:

To determine whether a community programme of screening for and eradication of H. pylori infection produces further benefit after an initial 2-year period, as judged by a reduction in GP consultations for dyspepsia.

METHODS:

A total of 1517 people aged 20-59 years, who were registered with seven general practices in Frenchay Health District, Bristol, had a positive (13)C-urea breath test for H. pylori infection and were entered into a randomized double-blind trial of H. pylori eradication therapy. After 2 years, we found a 35% reduction in GP consultations for dyspepsia (previously reported). In this extension to the study, we analysed dyspepsia consultations between two and 7 years after treatment.

RESULTS:

Between two and 7 years after treatment, 81/764 (10.6%) of participants randomized to receive active treatment consulted for dyspepsia, compared with 106/753 (14.1%) of those who received placebo, a 25% reduction, odds ratio 0.84 (0.71, 1.00), P = 0.042.

CONCLUSIONS:

Eradication of H. pylori infection in the community gives cumulative long-term benefit, with a continued reduction in the development of dyspepsia severe enough to require a consultation with a general practitioner up to at least 7 years. The cost savings resulting from this aspect of a community H. pylori eradication programme, in addition to the other theoretical benefits, make such programmes worthy of serious consideration, particularly in populations with a high prevalence of H. pylori infection.

• Authors: R F Harvey, J A Lane, P Nair, M Egger, I Harvey, J Donovan, L Murray
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 32 Issue 3 Pg. 394-400 (Aug 2010) ISSN: 1365-2036 [Electronic] England
• PMID: 20491744 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Chronic Disease
• Double-Blind Method
• Dyspepsia (diagnosis, economics, prevention & control)
• Female
• Helicobacter Infections (drug therapy, economics)
• Helicobacter pylori
• Humans
• Male
• Mass Screening (economics)
• Middle Aged
• Young Adult