Does Helicobacter pylori Eradication Affect Symptoms in Nonulcer Dyspepsia: A 5-Year Follow-Up Study

The role of Helicobacter pylori infection in nonulcer dyspepsia remains controversial. To date studies exploring the effect of H. pylori eradication on symptoms have reported conflicting results. Randomised control trials employing validated outcome measures have also been difficult to interpret bec...

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Veröffentlicht in:Helicobacter (Cambridge, Mass.) Mass.), 2002-10, Vol.7 (5), p.317-321
Hauptverfasser: McNamara, D., Buckley, M., Gilvarry, J., O'Morain, C.
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container_issue 5
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container_title Helicobacter (Cambridge, Mass.)
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creator McNamara, D.
Buckley, M.
Gilvarry, J.
O'Morain, C.
description The role of Helicobacter pylori infection in nonulcer dyspepsia remains controversial. To date studies exploring the effect of H. pylori eradication on symptoms have reported conflicting results. Randomised control trials employing validated outcome measures have also been difficult to interpret because of several important issues such as the large placebo response seen in patients with nonulcer dyspepsia and both the natural variability in symptoms and symptom severity with time. The association of symptom improvement with resolution of gastritis has meant that the length of follow up employed in most studies has been insufficient.  We report the findings of a randomised placebo controlled trial (n = 100), using a validated symptom questionnaire and 5 year follow up to determine the effect of H. pylori eradication on symptoms in nonulcer dyspepsia.  In all 64 that were reviewed at 5 years there was a significant difference between patients who were H. pylori negative and those who remained positive with regard to complete symptom resolution, consumption of relevant medications and peptic ulcer disease development, in favour of active treatment. There was a trend for gradual symptom improvement over time irrespective of H. pylori status, which may reflect the natural history of this condition. For those who remained symptomatic at 5 years, there was no difference in symptom severity based on H. pylori status.  The findings of this study support the use of H. pylori eradication in symptomatic patients with nonulcer dyspepsia both to induce symptom resolution and to prevent disease progression.
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The association of symptom improvement with resolution of gastritis has meant that the length of follow up employed in most studies has been insufficient.  We report the findings of a randomised placebo controlled trial (n = 100), using a validated symptom questionnaire and 5 year follow up to determine the effect of H. pylori eradication on symptoms in nonulcer dyspepsia.  In all 64 that were reviewed at 5 years there was a significant difference between patients who were H. pylori negative and those who remained positive with regard to complete symptom resolution, consumption of relevant medications and peptic ulcer disease development, in favour of active treatment. There was a trend for gradual symptom improvement over time irrespective of H. pylori status, which may reflect the natural history of this condition. 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To date studies exploring the effect of H. pylori eradication on symptoms have reported conflicting results. Randomised control trials employing validated outcome measures have also been difficult to interpret because of several important issues such as the large placebo response seen in patients with nonulcer dyspepsia and both the natural variability in symptoms and symptom severity with time. The association of symptom improvement with resolution of gastritis has meant that the length of follow up employed in most studies has been insufficient.  We report the findings of a randomised placebo controlled trial (n = 100), using a validated symptom questionnaire and 5 year follow up to determine the effect of H. pylori eradication on symptoms in nonulcer dyspepsia.  In all 64 that were reviewed at 5 years there was a significant difference between patients who were H. pylori negative and those who remained positive with regard to complete symptom resolution, consumption of relevant medications and peptic ulcer disease development, in favour of active treatment. There was a trend for gradual symptom improvement over time irrespective of H. pylori status, which may reflect the natural history of this condition. For those who remained symptomatic at 5 years, there was no difference in symptom severity based on H. pylori status.  The findings of this study support the use of H. pylori eradication in symptomatic patients with nonulcer dyspepsia both to induce symptom resolution and to prevent disease progression.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Drug Therapy, Combination</subject><subject>Dyspepsia - drug therapy</subject><subject>Dyspepsia - physiopathology</subject><subject>eradication</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Helicobacter Infections - complications</subject><subject>Helicobacter Infections - drug therapy</subject><subject>Helicobacter Infections - microbiology</subject><subject>Helicobacter pylori</subject><subject>Helicobacter pylori - drug effects</subject><subject>Humans</subject><subject>Male</subject><subject>Metronidazole - therapeutic use</subject><subject>Middle Aged</subject><subject>non-ulcer dyspepsia</subject><subject>Organometallic Compounds - therapeutic use</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Recurrence</subject><subject>Tetracycline - therapeutic use</subject><subject>Treatment Outcome</subject><issn>1083-4389</issn><issn>1523-5378</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM9v0zAUgCMEYj_gX0A-cUt4tpPYRlxK161IVXfYJsTJcuIXySWpg51ozX9PulbjyslP9vc9S1-SEAoZhbz8sstowXhacCEzBsAygPk-O7xJLl8f3s4zSJ7mXKqL5CrGHQAUPFfvkwvKuAJG2WVibzxGssbW1b4y9YCB9FPrgyOrYKyrzeD8niyaBuuBPExdP_guErcnW78f23rGb6bYYx-d-UoWpEh_oQnk1retf06fevIwjHb6kLxrTBvx4_m8Tp5uV4_Ldbq5v_uxXGzSOgeWp4ZKypQA1bDSSLQCsGRG8NxYYQ2rkIoSTNmgbYSoKmaUrCQiVdwqCVXBr5PPp7198H9GjIPuXKyxbc0e_Ri1YAXlOdAZlCewDj7GgI3ug-tMmDQFfSysd_oYUh9D6mNh_VJYH2b10_mPserQ_hPPSWfg2wl4di1O_71Yr1ebeZj19KS7OODhVTfhty4FF4X-ub3TTH6H7VIJveZ_AYA4mEs</recordid><startdate>200210</startdate><enddate>200210</enddate><creator>McNamara, D.</creator><creator>Buckley, M.</creator><creator>Gilvarry, J.</creator><creator>O'Morain, C.</creator><general>Blackwell Science Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200210</creationdate><title>Does Helicobacter pylori Eradication Affect Symptoms in Nonulcer Dyspepsia: A 5-Year Follow-Up Study</title><author>McNamara, D. ; 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The association of symptom improvement with resolution of gastritis has meant that the length of follow up employed in most studies has been insufficient.  We report the findings of a randomised placebo controlled trial (n = 100), using a validated symptom questionnaire and 5 year follow up to determine the effect of H. pylori eradication on symptoms in nonulcer dyspepsia.  In all 64 that were reviewed at 5 years there was a significant difference between patients who were H. pylori negative and those who remained positive with regard to complete symptom resolution, consumption of relevant medications and peptic ulcer disease development, in favour of active treatment. There was a trend for gradual symptom improvement over time irrespective of H. pylori status, which may reflect the natural history of this condition. 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subjects Adolescent
Adult
Aged
Aged, 80 and over
Anti-Bacterial Agents - therapeutic use
Drug Therapy, Combination
Dyspepsia - drug therapy
Dyspepsia - physiopathology
eradication
Female
Follow-Up Studies
Helicobacter Infections - complications
Helicobacter Infections - drug therapy
Helicobacter Infections - microbiology
Helicobacter pylori
Helicobacter pylori - drug effects
Humans
Male
Metronidazole - therapeutic use
Middle Aged
non-ulcer dyspepsia
Organometallic Compounds - therapeutic use
Randomized Controlled Trials as Topic
Recurrence
Tetracycline - therapeutic use
Treatment Outcome
title Does Helicobacter pylori Eradication Affect Symptoms in Nonulcer Dyspepsia: A 5-Year Follow-Up Study
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