Table 2.
Definition of dyspepsia and symptom assessment.
| Studies | Definition of Dyspepsia | Duration of Dyspepsia | Severity of Dyspepsia Assessment | Quality of Life Assessment | Treatment Success | H. pylori Test | Post-Eradication Test | Allowance for Medication |
|---|---|---|---|---|---|---|---|---|
| McColl, 1998 [9] | Intermittent or persistent pain or discomfort in the upper abdomen, heartburn, nausea, a feeling of postprandial fullness, or any other symptoms thought to be related to the upper GI tract | 4 Mo | GDSS | SF-36 | A score of 0 or 1 on the GDSS | UBT, CLO, Histology | UBT | The patients could take any medication necessary, including PPI |
| Blum, 1998 [10] | Dyspeptic symptoms (specifically, pain or discomfort centered in the upper abdomen) that had been present for at least six months | 6 Mo | Mean symptom score by Likert score | GSRS, Psychological General Well-Being Index | No symptoms or no more than minimal pain or discomfort (a score of 0 or 1) centered in the upper abdomen during any of the 7 days preceding the 12 month visit | UBT, CLO, Histology | UBT, CLO, Histology | Not specified |
| Talley, 1999 [11] | Moderate pain of discomfort centered in the upper abdomen as their predominant symptom for a minimum of three days in the week | 3 Mo | GSRS | SF-36 | No more than mild pain or discomfort centered in the upper abdomen (a score of 0 or 1) during the 7 days before the final visit | UBT | UBT, Histology | Antacid was dispensed at each visit |
| Talley, 1999 (ORCHID) [12] | Pain or discomfort centered in the upper abdomen | 3 Mo | Dyspeptic symptoms using validated Likert scale (0–4) | GSRSPsychological General Well-Being Index | No more than minimal dyspeptic symptoms during any of the 7 days before the 12 month visit | UBT, CLO, Histology | UBT, Histology | Patients could receive treatment for dyspeptic symptoms from their doctor, but all drugs used were recorded |
| Varannes, 2001 [13] | Intermittent or persistent epigastric pain for at least 3 months with a severity score of 3 or more on a 5-point Likert scale | 3 Mo | Likert scale (0–4) | SF-36 | A decrease of at least 2 points on the Likert scale between randomization and the 12 month follow-up | CLO, Histology | UBT | Rescue symptomatic medications could be prescribed from day 8 until the end of the study, provided they were not anti-secretory drugs or sucralfate |
| Koskenpato, 2001 [14] | Dyspeptic symptoms | 3 Mo | Numeric scale questionnaire validated in a Finnish population (0–36) | SF-36 | Reduction of symptom score ≥ 50% | CLO, Histology, Culture | CLO, Histology, Culture | Omeprazole 20 mg daily for the first 3 months and thereafter placebo during the follow-up |
| Froehlich, 2001 [15] | Epigastric complaints (symptom score > 7 on a sum score ranging from 5 to 25) | 10 days | Validated questionnaire (5–25) | SF-12 | Symptom score less than 7 | UBT, CLO, Histology | UBT | Not specified |
| Hsu, 2001 [16] | Pain or discomfort centered in the upper abdomen | 3 Mo | Validated questionnaire (0–15) | N/A | Resolution of symptoms, defined as a score below 3 | CLO, Histology | UBT, CLO, Histology | Subjects were allowed to take antacids or prokinetics (H2 blocker or PPI were forbidden) but not during the month before each interview |
| Malfertheiner, 2003 [17] | Patients seeking medical care for dyspeptic symptom | 4 wk | Non-ulcer dyspepsia sum score | Non-ulcer dyspepsia sum score of ≤1 | CLO | UBT | Not specified | |
| Zanten, 2003 [18] | Rome definition: chronic or frequently recurring epigastric pain which could be associated with other upper GI symptoms | 3 Mo | MDSS | Patients were classified as responders if they had a decrease of ≥4 points on the DSS. If patients required H2 blocker, PPI or prokinetics, they were considered as non-responders | UBT, CLO, Histology | UBT | Patients were given aluminum hydroxide-magnesium hydroxide as a rescue antacid | |
| Gisbert, 2004 [19] | Pain or discomfort centered in the upper abdomen | 3 Mo | Five-point Likert scale | N/A | CLO, Histology | UBT | No anti-secretory therapy was allowed | |
| Mazzoleni, 2006 [20] | Pain or discomfort centered in the upper abdomen | 3 Mo | PADYQ (0–44) | N/A | The proportion of patients presenting a decrease of 50% or more in dyspeptic scores at 12 months compared with the baseline score | CLO, Histology | CLO, Histology | During the study, patients were allowed to use H2 blocker and/or prokinetics to treat dyspeptic symptoms |
| Ang, 2006 [21] | Pain or discomfort centered in the upper abdomen | 3 Mo | GDSS | N/A | The resolution of symptoms, defined as a score of 0 or 1 on the GDSS at 1 year | UBT, CLO | UBT, CLO | Not specified |
| Gwee, 2009 [22] | Rome II criteria | 3 Mo | Dyspepsia score (0–15) | General Health Questionnaire | Symptom resolution was defined as a dyspepsia score of 0 or 1 at the 12 month | UBT | UBT | H2 blocker, antacids, prokinetics were allowed |
| Mazzoleni, 2011 [23] | Rome III criteria | 3 Mo | PADYQ (0–44) | N/A | Proportion of patients with at least a 50% decrease in the dyspeptic symptoms score at 12 months compared with their baseline score. | CLO, Histology | CLO, Histology | H2 blockers and prokinetics were allowed |
| Xu, 2013 [24] | Rome III criteria | 3 Mo | GSRS | N/A | Improvement more than 50% by symptom score | CLO, Histology | UBT | Talcid and domperidone were allowed for control group |
| Sodhi, 2013 [25] | Rome II criteria | 3 Mo | 7-points Likert scales | N/A | Patients who reported no more than minimal dyspeptic symptoms (0 or 1) during any of the 7 days before each visit | CLO, Histology | CLO, Histology | |
| Yazdanbod, 2015 [26] | Rome III criteria | 3 Mo | GDSS (0–20) | N/A | Presence of no more than mild pain or discomfort (a score of 0 or 1) | CLO, Histology | UBT |
CLO, Campylobacter-like organism test; GDSS, Glasgow dyspepsia severity score; GSRS, gastrointestinal symptom rating scale; H2, histamine 2; H. pylori, Helicobacter pylori; Mo, months; MDSS, mean dyspepsia summary score; PADYQ, Porto Alegre dyspeptic symptoms questionnaire; PPI, proton pump inhibitor; SF-36, 36 item medical outcomes study short-form general health survey; UBT, urea breath test; wk, weeks.