Long-term prospective study ofHelicobacter pylori in nonulcer dyspepsia

McCarthy, Conor; Patchett, Stephen; Collins, R.; Beattie, S.; Keane, C. T.; O’Moráin, Colm

doi:10.1007/bf02063953

Cited by 131 publications

(66 citation statements)

References 25 publications

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“…The need for longterm follow-up in NUD trials was highlighted by a study of 84 patients receiving eradication therapy followed-up for 1 year. 206 H. pylori was eradicated in 49% of patients and, initially, there was no difference in dyspepsia symptoms between infected and uninfected cases. There was, however, a significant improvement in dyspepsia scores in H. pylori-eradicated patients compared with those remaining infected at 1 year.…”

Section: Introductionmentioning

confidence: 91%

“…Nevertheless, it emphasises the need for longterm follow-up in trials assessing H. pylori eradication in NUD. 206 Recently, a number of large, well-designed, placebo-controlled trials evaluating H. pylori therapy in NUD have been conducted. 207,208 These have avoided the criticisms of earlier studies but have still given conflicting results.…”

Section: Introductionmentioning

confidence: 99%

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The management of dyspepsia: a systematic review.

Delaney

Moayyedi²,

Deeks³

et al. 2000

Health Technology Assessment

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Section: Introductionmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

The management of dyspepsia: a systematic review.

Delaney

Moayyedi²,

Deeks³

et al. 2000

Health Technology Assessment

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“…Early reports on the coexistence of gastritis in patients with reflux oesophagitis or reflux symptoms may suggest gastritis, especially of the cardias, as one such factor [7][8][9]. On the other hand, the demonstration of a close relationship between Helicobacter pylori gastritis and peptic ulcer [10][11][12][13] suggested a similar correlation between H. pylori gastritis and non-ulcer dyspepsia, especially with ulcer-like symptoms [9,[14][15][16], despite controversial findings [17,18] and considerable criticism [19].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Gastroduodenitis and Oesophagitis in Relation to Dyspeptic/Reflux Symptoms

Villani¹,

Trespi²,

Fiocca³

et al. 1998

Digestion

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Background/Aims: The pathogenesis of dyspeptic/reflux symptoms and the clinico-pathologic profile of affected patients are still poorly understood. To improve our knowledge in this field we carried out a systematic, comparative analysis of symptom profiles and histopathologic patterns of oesophagogastroduodenal mucosa in a series of 221 subjects, 140 with and 81 without endoscopic evidence of hiatal hernia. Of these, 190 showed reflux and/or dyspeptic symptoms. Methods: Before endoscopy, all the subjects were questioned about the presence and severity of 12 individual symptoms. Biopsies were taken from the distal oesophagus, cardia, corpus, angulus, antrum and duodenal bulb, and were scored in accordance with the Sydney system. Results: Patient groups with a distinct clinico-pathologic profile were better identified when symptoms of adequate severity were compared with histopathologic parameters. A correlation between gastroesophageal reflux disease (GORD) symptoms and histologic signs of oesophagitis was mostly restricted to patients endoscopically positive for oesophagitis. Retroxiphoid pyrosis correlated with cardial gastritis but not with oesophagitis, either endoscopic or histologic, while ulcer-like epigastric pain correlated with active duodenitis and distal gastritis. No definite histopathologic background was detected in patients with putative dysmotility-like symptoms, endoscopy-negative GORD and low score or mixed symptoms. Conclusion: A contribution of Helicobacter pylori gastroduodenitis to the pathogenesis of some dyspeptic symptoms seems likely. However, the identification of specific histologic changes causing individual symptoms remains rather elusive, with the exception of active antroduodenitis in patients with ulcer-like pain and of active proximal gastritis in patients with severe retroxiphoid pyrosis.

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“…Several studies have produced contradictory results. McCarthy et al (16) studied 83 patients with functional dyspepsia and HP and reported significantly impaired symptoms in untreated patients or those with reinfection.…”

mentioning

confidence: 99%

Eradication of Helicobacter pylori infection in patients with duodenal ulcer and non-ulcer dyspepsia and analysis of one-year reinfection rates

Líbera

Röhr

Moraes

et al. 2001

Braz J Med Biol Res

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Helicobacter pylori (HP) infection is endemic worldwide. The proposed treatment is expensive and there are few reports regarding reinfection rates in Brazil. The aim of this study was to compare the eradication rates obtained with two therapeutic options and to evaluate reinfection one year after treatment. This was a prospective randomized trial with 55 patients. Thirty-nine patients had active duodenal ulcer (DU) and 16 non-ulcer dyspepsia (NUD), and all tested positive for HP. Diagnosis was based on at least two positive tests: ultrarapid urease test, histology and/or culture. Patients were randomized to two groups: group OMC treated with 40 mg omeprazole (once a day), 500 mg metronidazole and 250 mg clarithromycin (twice daily) for 7 days, or group NA treated with 300 mg nizatidine (once a day) and 1000 mg amoxicillin (twice daily) for 14 days. Those patients in whom HP was eradicated were followed up for one year to evaluate reinfection. Twenty-five patients were randomized for OMC and 30 for NA. HP eradication occurred in 20/25 patients (80%) treated with OMC and 13/30 (43%) treated with NA (P = 0.01). After reallocation because of initial treatment failure, the overall eradication rate was 44/51 patients (86%). After an average follow-up of one year, we evaluated 34 patients (23 with DU and 11 with NUD). Reinfection occurred in 3/34 patients (7.6%). We conclude that OMC is effective for HP eradication, and that NA should not be used. Reinfection occurs in 7.6% of the patients in the first year after eradication.

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Long-term prospective study ofHelicobacter pylori in nonulcer dyspepsia

Cited by 131 publications

References 25 publications

The management of dyspepsia: a systematic review.

The management of dyspepsia: a systematic review.

Analysis of Gastroduodenitis and Oesophagitis in Relation to Dyspeptic/Reflux Symptoms

Eradication of Helicobacter pylori infection in patients with duodenal ulcer and non-ulcer dyspepsia and analysis of one-year reinfection rates

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