Is Helicobacter pylori associated with non-ulcer dyspepsia and will eradication improve symptoms? A meta-analysis

Abstract

Objectives To examine the association between Helicobacter pylori infection and non-ulcer dyspepsia, and to assess the effect of eradicating H pylori on dyspeptic symptoms in patients with non-ulcer dyspepsia. Design Systematic review and meta-analysis of (a) observational studies examining the association between Helicobacter pylori infection and non-ulcer dyspepsia (association studies), and (b) therapeutic trials examining the association between eradication of H pylori and dyspeptic symptoms in patients with non-ulcer dyspepsia (eradication trials).

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

“…The present systematic review of studies on H pylori and dyspepsia involves more than 3 times as many patients in observational studies (9818 vs 2764 patients) and almost 3 times as many in randomized trials of H pylori eradication (2340 vs 778 patients) as were in a 1999 update 88 of previous reviews. 10,11 Moreover, whereas these previous reviews inappropriately combined results from substantially different observational studies (eg, those involving different diseases and/or different study designs) and results from substantially different trials (eg, those with brief vs prolonged follow-up), the present review avoids such potential biases and the misleading claims that may arise from them.…”

Triple therapy with clarithromycin, amoxicillin and omeprazole for Helicobacter pylori eradication in children and adolescents

“…A metaanalysis of a large number of controlled studies indicated that the presence of Hp gastritis in the absence of peptic ulcer may be a risk factor in non-ulcer dyspepsia (odds ratio 1.6, IC(95%) = 1.4-1.8) and symptoms improve when the organism is successfully eradicated (1.9, IC(95%) = 1.3-2.6) (10) . In children a positive correlation between Hp gastritis without peptic ulcer and dyspeptic symptoms or recurrent abdominal pain (17) has not been well established (8,14,22) .…”

Helicobacter Pylori, Non-Ulcer Dyspepsia, and Childhood Recurrent Abdominal Pain

“…Two systematic reviews have provided conflicting results regarding the effect of H. pylori eradication on symptom resolution in patients with non-ulcer dyspepsia (2,3). These reviews, however, have been criticized on methodological grounds.…”

“…Non-ulcer dyspepsia is defined as persistent or recurrent upper abdominal discomfort, of at least 12 weeks duration, with no evidence of organic disease on investigation. The prevalence of non-ulcer dyspepsia in adults is around 10% and H. pylori infection is slightly more prevalent in adults with non-ulcer dyspepsia compared with healthy controls (2).…”