Eradication of Helicobacter pylori prevents ulcer development in patients with ulcer-like functional dyspepsia

Authors


Dr Kwok-HungLai, Department of Internal Medicine, Kaohsiung Veterans General Hospital, 386 Ta-Chung 1st Road, Kaohsiung, Taiwan, Republic of China. E-mail: hsupi@kimo.com.tw

Abstract

Background:

Although the eradication of Helicobacter pylori infection benefits patients with gastric or duodenal ulcers, the value of eradicating the infection in the patients with functional dyspepsia (FD) remains controversial.

Aims:

To determine whether eradicating H. pylori can prevent the subsequent development of ulcers or relieve the symptoms of functional dyspepsia patients.

Methods:

In a double-blind, placebo-controlled trial, 161 patients infected with H. pylori who had functional dyspepsia were randomly assigned to 7 days of treatment with a lansoprazole-based triple therapy or placebo and then followed for 1 year. The main outcome measures were the development of peptic ulcers and the resolution of symptoms.

Results:

H. pylori was eradicated in 63 out of 81 patients (78%) in the treatment group and none of the 80 patients (0%) in the placebo group. During the follow-up period, two patients in the treatment group and six patients in the placebo group developed peptic ulcers at repeat endoscopy (2.5% vs. 7.5%; 95% CI: –12 to 2). The reduction in ulcer rates was statistically significant in the ‘ulcer-like’ sub-group (0% vs. 16.7%; 95% CI: –32 to –2), but not in the ‘dysmotility-like’ and ‘unclassifiable’ sub-groups. Regarding symptom response, the resolution rates of symptoms were similar between the treatment and placebo groups (58.0% vs. 55.0%, 95% CI: –12 to 18). Additionally, no significant differences existed in the symptom responses between the treatment and control arms in each of the dyspepsia sub-groups.

Conclusions:

Eradicating H. pylori can prevent the subsequent development of peptic ulcers in the patients with ‘ulcer-like’ functional dyspepsia. However, this approach does not significantly reduce the symptoms of functional dyspepsia patients.

Ancillary