Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1991 Nov 16;303(6812):1238–1240. doi: 10.1136/bmj.303.6812.1238

Eradicating Helicobacter pylori and symptoms of non-ulcer dyspepsia.

S Patchett 1, S Beattie 1, E Leen 1, C Keane 1, C O'Morain 1
PMCID: PMC1671549  PMID: 1747644

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.

Full text

PDF
1240

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adami H. O., Agenäs I., Gustavsson S., Löf L., Nyberg A., Nyrén O., Tyllström J. The clinical diagnosis of 'gastritis'. Aspects of demographic epidemiology and health care consumption based on a nationwide sample survey. Scand J Gastroenterol. 1984 Mar;19(2):216–219. [PubMed] [Google Scholar]
  2. Barthel J. S., Westblom T. U., Havey A. D., Gonzalez F., Everett E. D. Gastritis and Campylobacter pylori in healthy, asymptomatic volunteers. Arch Intern Med. 1988 May;148(5):1149–1151. [PubMed] [Google Scholar]
  3. Coghlan J. G., Gilligan D., Humphries H., McKenna D., Dooley C., Sweeney E., Keane C., O'Morain C. Campylobacter pylori and recurrence of duodenal ulcers--a 12-month follow-up study. Lancet. 1987 Nov 14;2(8568):1109–1111. doi: 10.1016/s0140-6736(87)91545-5. [DOI] [PubMed] [Google Scholar]
  4. Heatley R. V., Rathbone B. J. Dyspepsia: a dilemma for doctors? Lancet. 1987 Oct 3;2(8562):779–782. doi: 10.1016/s0140-6736(87)92509-8. [DOI] [PubMed] [Google Scholar]
  5. Lambert J. R., Dunn K., Borromeo M., Korman M. G., Hansky J. Campylobacter pylori--a role in non-ulcer dyspepsia? Scand J Gastroenterol Suppl. 1989;160:7–13. doi: 10.3109/00365528909091728. [DOI] [PubMed] [Google Scholar]
  6. Loffeld R. J., Potters H. V., Stobberingh E., Flendrig J. A., van Spreeuwel J. P., Arends J. W. Campylobacter associated gastritis in patients with non-ulcer dyspepsia: a double blind placebo controlled trial with colloidal bismuth subcitrate. Gut. 1989 Sep;30(9):1206–1212. doi: 10.1136/gut.30.9.1206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Marshall B. J., Armstrong J. A., McGechie D. B., Glancy R. J. Attempt to fulfil Koch's postulates for pyloric Campylobacter. Med J Aust. 1985 Apr 15;142(8):436–439. doi: 10.5694/j.1326-5377.1985.tb113443.x. [DOI] [PubMed] [Google Scholar]
  8. Marshall B. J., Warren J. R. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet. 1984 Jun 16;1(8390):1311–1315. doi: 10.1016/s0140-6736(84)91816-6. [DOI] [PubMed] [Google Scholar]
  9. Morris A., Nicholson G. Ingestion of Campylobacter pyloridis causes gastritis and raised fasting gastric pH. Am J Gastroenterol. 1987 Mar;82(3):192–199. [PubMed] [Google Scholar]
  10. Morris A., Nicholson G., Lloyd G., Haines D., Rogers A., Taylor D. Seroepidemiology of Campylobacter pyloridis. N Z Med J. 1986 Sep 10;99(809):657–659. [PubMed] [Google Scholar]
  11. Rauws E. A., Langenberg W., Houthoff H. J., Zanen H. C., Tytgat G. N. Campylobacter pyloridis-associated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology. 1988 Jan;94(1):33–40. [PubMed] [Google Scholar]
  12. Rokkas T., Pursey C., Uzoechina E., Dorrington L., Simmons N. A., Filipe M. I., Sladen G. E. Non-ulcer dyspepsia and short term De-Nol therapy: a placebo controlled trial with particular reference to the role of Campylobacter pylori. Gut. 1988 Oct;29(10):1386–1391. doi: 10.1136/gut.29.10.1386. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES