Abstract
The potential role of Helicobacter pylori as an aetiological agent for non-ulcer dyspepsia has long been a controversial topic. Numerous studies purported to assess the effect of H. pylori eradication therapy in non-ulcer dyspepsia during the first decade of the ‘H. pylori era’, but serious methodological flaws were present in all, preventing conclusions regarding the utility of H. pylori eradication therapy in this setting1. Only in the past few years have well-designed trials been performed. As will be discussed, most of the trials of highest quality have failed to show a significant improvement in treatment success for non-ulcer dyspepsia after H. pylori eradication treatment. Furthermore, most of these trials were powered to demonstrate what the authors felt would be a clinically significant difference in favour of H. pylori treatment. However, it is possible that a smaller benefit could have been missed in these trials. This possibility led to the performance of meta-analyses to assess the effect of H. pylori eradication on the symptoms of non-ulcer dyspepsia.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Talley NJ. A critique of therapeutic trials in Helicobacter pylori-positive functional dyspepsia. Gastroenterology. 1994; 106: 1174–83.
Laine L, Schoenfeld P, Fennerty MB. Helicobacter pylori therapy for treatment of non-ulcer dyspepsia: a meta-analysis of randomized controlled trials. Ann Intern Med. 2001; 134: 361–9.
McColl K, Murray L, El-Omar E et al. Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med. 1998; 339: 1869–74.
Talley NJ, Colin Jones D, Koch KL, Koch M, Nyren O, Stanghellini V. Functional dyspepsia: a classification with guidelines for diagnosis and management. Gastroenterol Int. 1991; 4: 145–60.
Talley NJ, Silverstein MD, Agreus L, Nyren O, Sonnenberg A, Holtmann G. AGA Technical Review: Evaluation of dyspepsia. Gastroenterology. 1998; 114: 582–95.
Talley NJ, Stanghellini V, Heading RC, Koch KL, Malagelada JR, Tytgat GNJ. Functional gastroduodenal disorders. Gut. 1999; 45 (Suppl. 14): 1137–42.
Moayyedi P, Soo S, Deeks J et al. Eradication of Helicobacter pylori for non-ulcer dyspepsia. Cochrane Database of Systematic Reviews. 2001.
Malfertheiner P, Fischbach W, Layer P et al. ELAN study proves symptomatic benefit of Helicobacter pylori eradication in functional dyspepsia (FD). Gastroenterology. 2000; 118: A440.
Talley NJ, Janssens J, Lauritsen K, Racz I, Bolling-Sternevald E. Eradication of Helicobacter pylori in functional dyspepsia: randomised double-blind placebo controlled trial with 12 months’ follow up. Br Med J. 1999; 318: 833–7.
Blum AL, Talley NJ, O’Morain C et al. Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med. 1998; 339: 1875–81.
Talley NJ, Vakil N, Ballard ED II, Fennerty MB. Absence of benefit of eradicating Helicobacter pylori in patients with nonulcer dyspepsia. N Engl J Med. 1999; 341: 1106–11.
David J, Lee A, Forbes N, Patel G, Terrany B, Ozick LA. Helicobacter pylori eradication for non-ulcer dyspepsia: a prospective, double-blind, randomized, placebo-controlled study. Gastroenterology. 1996; 110: A91.
Koelz HR, Arnold R, Stolte M, Blum AL. Treatment of Helicobacter pylori (HP) does not improve symptoms of functional dyspepsia (FD). Gastroenterology. 1998; 114: A182.
Passos MCF, Coelho LGV, Gloria ALF et al. H. pylori eradication for functional dyspepsia: a long-term, randomized, prospective, double-blind, placebo-controlled study. Gut. 1998; 43 (Suppl. 2): A81.
Koskenpato J, Farkkila M, Sipponen P. Helicobacter pylori eradication and standardized 3-month omeprazole therapy in functional dyspepsia. Am J Gastroenterol. 2001; 96: 2866–72.
Des Varannes SB, Flejou JF, Colin R, Zaim M, Meunier A, Bidaut-Mazel C. There are some benefits for eradicating Helicobacter pylori in patients with non-ulcer dyspepsia. Aliment Pharmacol Ther. 2001; 15: 1177–85.
Miwa H, Hirai S, Nagahara A et al. Cure of Helicobacter pylori does not improve symptoms in non-ulcer dyspepsia patients — a double-blind placebo-contrlled study. Aliment Pharmacol Ther. 2000; 14: 317–24.
Hsu PI, Lai KH, Tseng HH et al. Eradication of Helicobacter pylori prevents ulcer development in patients with ulcer-like dyspepsia. Aliment Pharmacol Ther. 2001; 15: 951–201.
Froelich F, Gonvers JJ, Wietlisbach V et al. Helicobacter pylori eradication treatment does not benefit patients with nonulcer dyspepsia. Am J Gastroenterol. 2001; 96: 2329–36.
Greenberg PD, Cello JP. Lack of effect of treatment for Helicobacter pylori on symptoms of nonulcer dyspepsia. Arch Intern Med. 1999; 159: 2283–8.
Dhali GK, Garg PK, Sharma MP. Role of anti-Helicobacter pylori treatment in H. pylori-positive and cytoprotective drugs in H. pylori-negative, non-ulcer dyspepsia: results of a randomized, double-blind, controlled trial in Asian Indians. J Gastroenterol Hepatol. 1999; 14: 523–8.
Sheu BS, Lin CY, Lin XZ, Shiesh SC, Yang HB, Chen CY. Long-term outcome of triple therapy in Helicobacter pylori-related nonulcer dyspepsia: a prospective controlled assessment. Am J Gastroenterol. 1996; 91: 441–7.
McColl KE. Absence of benefit of eradicating Helicobacter pylori in patients with nonulcer dyspepsia. N Engl J Med. 2000; 342: 589–90.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2003 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Laine, L. (2003). Helicobacter pylori eradication does not benefit non-ulcer dyspepsia. In: Hunt, R.H., Tytgat, G.N.J. (eds) Helicobactor pylori. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-1763-2_28
Download citation
DOI: https://doi.org/10.1007/978-94-017-1763-2_28
Publisher Name: Springer, Dordrecht
Print ISBN: 978-90-481-5778-5
Online ISBN: 978-94-017-1763-2
eBook Packages: Springer Book Archive