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. 1998 May;42(5):618–622. doi: 10.1136/gut.42.5.618

Assessment of symptomatic response as predictor of Helicobacter pylori status following eradication therapy in patients with ulcer

K McColl 1, A El-Nujumi 1, L Murray 1, E El-Omar 1, A Dickson 1, A Kelman 1, T Hilditch 1
PMCID: PMC1727091  PMID: 9659153

Abstract

Background—Helicobacter pylori eradication therapy is routinely used for treating patients with peptic ulcer disease. 
Aims—To assess the value of symptomatic response to H pylori eradication therapy as a marker of post-treatment H pylori status. 
Patients and methods—One hundred and nine dyspeptic patients with active duodenal or gastric ulceration associated with H pylori infection had their symptoms measured by a validated questionnaire before and three months following H pylori eradication therapy. The symptomatic response was compared with post-treatment H pylori status as determined by the 14C urea breath test. 
Results—An eradication rate of 84% was achieved. Of the 92 patients eradicated of H pylori, 47% experienced complete or near complete resolution of dyspepsia. Of the 17 patients in whom the infection was not eradicated, only one (6%) experienced resolution of dyspepsia. Resolution of dyspepsia was therefore a powerful predictor of eradication of H pylori with a predictive value of 98%. In contrast, persistence of dyspepsia was a weak predictor of persisting infection with a predictive value of only 25%. Excluding patients with endoscopic evidence of coexisting oesophagitis and/or retrosternal discomfort or reflux at initial presentation did not increase the predictive value of persisting dyspepsia for persisting infection. 
Conclusions—Complete resolution of dyspeptic symptoms is a powerful predictor of eradication of H pylori infection in ulcer patients. Persistence of symptoms is a weak predictor of persisting infection and patients with persisting dyspepsia must have their H pylori status rechecked to guide future management. 



Keywords: Helicobacter pylori; dyspepsia; ulcer disease; eradication therapy; reflux disease

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Figure 1 .

Figure 1

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Individual dyspepsia scores in the ulcer patients before and after successful and unsuccessful H pylori eradication therapy. 


Figure 2 .

Figure 2

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ROC curve for various post-treatment dyspepsia scores for predicting eradication of H pylori. 


Selected References

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

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