Association between subjects with dyspeptic sumptoms and Helicobacter pylori infection: Epidemilogic study conducted at 16 centers in Argentina

Systematic Review of the Epidemiological Evidence on Helicobacter pylori Infection and Nonulcer or Uninvestigated Dyspepsia

“…Since the first report in 1987, 41 observational epidemiological studies (31 peer-reviewed articles* and 10 abstracts 26,27,41,43,50,56,[62][63][64] ) from 19 different countries have reported on associations between H pylori and dyspepsia ( Figures 1 and 2): 30 studies involved a total of 3392 patients with nonulcer dyspepsia (mean weighted age, 44 years; 56% males; Figure 1), in which individuals with any detectable upper gastrointestinal tract lesion should generally have been excluded after clinical examination and endoscopy, and the remaining 11 studies involved a total of 6426 patients with uninvestigated dyspepsia (weighted mean age, 45 years; 49% males; Figure 2), in which gastrointestinal symptoms had generally been assessed on the basis of postal or other questionnaires.…”

“…Several of these studies 26,27,34,43,51 of nonulcer dyspepsia used laboratory-based enzyme-linked immunoassays to measure serum IgG antibodies to H pylori. These antibodies are fairly reliable indicators of chronic gastric infection with H pylori, and, in the absence of specific treatment, titers generally persist from early life, when the infection is typically acquired.…”

“…Figure 1 also shows that the 99% CIs in the published studies of nonulcer dyspepsia involve more than 2-fold uncertainty owing to the small numbers of patients: for example, only 2 studies 27,38 involved more than 100 patients and 100 controls. But, although a previously published meta-analysis 10 pooled the results of 19 published studies involving a total of 2700 patients with nonulcer or uninvestigated dyspepsia to report a combined OR of 2.3 (95% CI, 1.9-2.7) for H pylori infection in dyspepsia, its conclusions are potentially misleading * References 28,29,31,33,36,37,39,40,44,45,48,49. Olmos et al, 27 1998…”

Patients with dyspepsia benefit from eradication of helicobacter pylori if other organic causes for dyspepsia were carefully ruled out

“…Patients with dyspepsia benefit from era d i c a t i o n of helicobacter pyl o ri if other organic causes fo r d yspepsia we re care f u l ly ruled out 1 BO JARSKI, Ch., 1 EPPLE, H.-J., 1 3…”

“…So far, the role of HP-infection in dyspepsia is uncertain. Whether or not the prevalence of HP-infection is increased in dyspeptic patients is controversial (1)(2)(3)(4)(5) and -as discussed in several metaanalyses -so is the question whether cure of HP-infection leads to significant improvement of the symptoms in these patients (6,7). However, with observation periods of up to eight we e ks the inte rventional studies included in these metaanalyses did not assess the effect of HP-eradication on dyspeptic symptoms over the long-term.…”