Eradicating Helicobacter pylori and symptoms of non-ulcer dyspepsia.

Abstract

OBJECTIVE:

To examine the effect of eradication of Helicobacter pylori on symptoms of non-ulcer dyspepsia.

DESIGN:

Four week prospective study.

SETTING:

One hospital outpatient and endoscopy department.

PATIENTS:

90 adults with persistent symptoms typical of non-ulcer dyspepsia but no clinical or endoscopic evidence of other peptic, biliary, pancreatic, or malignant disease; all had histological and microbiological evidence of infection with H pylori. 83 patients completed the treatment regimen.

INTERVENTION:

Colloidal bismuth subcitrate 120 mg four times a day for four weeks (27 patients); metronidazole 400 mg and amoxycillin 500 mg each three times a day for one week (27); and bismuth subcitrate 120 mg four times a day for four weeks, metronidazole 400 mg three times a day for one week, plus amoxycillin 500 mg three times a day for the first week (29).

MAIN OUTCOME MEASURES:

Change in symptom scores determined with questionnaire; histological evidence of gastritis and microbiological evidence of presence of H pylori in biopsy specimens.

RESULTS:

Overall, H pylori was eradicated in 41 (49%) patients. Although gastritis scores improved significantly in only patients in whom H pylori had been eradicated (from 1.56 to 0.61, p less than 0.01 v from 1.83 to 1.07, p = 0.52) mean symptom scores after treatment were similar in patients in whom H pylori had or had not been eradicated (3.0 v 2.3, NS). Similarly the mean symptom score improved whether or not gastritis improved (2.8 v 3.1 respectively, p = 0.72). The observations were similar for treatment groups analysed individually.

CONCLUSION:

Antral infection with the organism does not seem to have an important aetiological role in non-ulcer dyspepsia short term.

• Authors: S Patchett, S Beattie, E Leen, C Keane, C O'Morain
• Journal: BMJ (Clinical research ed.) (BMJ) Vol. 303 Issue 6812 Pg. 1238-40 (Nov 16 1991) ISSN: 0959-8138 [Print] England
• PMID: 1747644 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article)

Chemical References

• Organometallic Compounds
• Metronidazole
• Amoxicillin
• bismuth tripotassium dicitrate
• Bismuth

Topics

• Adult
• Aged
• Amoxicillin (administration & dosage, therapeutic use)
• Bismuth (administration & dosage, therapeutic use)
• Drug Administration Schedule
• Drug Therapy, Combination
• Dyspepsia (complications, drug therapy)
• Female
• Helicobacter Infections (complications, drug therapy)
• Helicobacter pylori
• Humans
• Male
• Metronidazole (administration & dosage, therapeutic use)
• Middle Aged
• Organometallic Compounds (administration & dosage, therapeutic use)
• Prospective Studies