Is Helicobacter pylori the cause of dyspepsia?
OBJECTIVE
To determine the association between infection with Helicobacter pylori and dyspepsia.


METHODS
Cross sectional study of dyspeptic subjects and age and sex matched controls identified by a questionnaire survey of all inhabitants aged 20-69. (Endoscopy, histological examination, and microbiological examinations of biopsies from the gastric mucosa were performed blind.)


METHODS
Population based survey in Sørreisa, Norway.


METHODS
All 782 dyspeptic subjects (excluding those with a previous history of peptic ulcer, gall stones or kidney stones, and coronary heart disease) and controls were offered an endoscopy, of whom 309 dyspeptic subjects and 310 controls attended.


METHODS
Prevalences of endoscopic and histological diagnoses and of cultures positive for H pylori.


RESULTS
A high prevalence of positive cultures, increasing with age, was found in both dyspeptic subjects (48%) and non-dyspeptic controls (36%) (p = 0.004). Positive cultures in both dyspeptic subjects and controls were strongly associated with histological gastritis (70%, 95% confidence interval 65.5 to 85.3; 60%, 52.7 to 67.7, respectively) and peptic ulcer (92%, 61.5 to 99.8; 64.1, 9.4 to 99.2, respectively). Only 3% of subjects with a histologically non-inflamed gastric mucosa had this infection (dyspeptic subjects 2%, 0.2 to 7.0; controls 4%; 1.2 to 8.8).


CONCLUSIONS
The relation between dyspeptic symptoms and H pylori is dubious; H pylori seems to have a pathogenetic role in gastritis and may be a contributing factor but not a cause of peptic ulcer.
Bernersen
B
B
Institute of Community Medicine, University of Tromsø, Norway.
Johnsen
R
R
Bostad
L
L
Straume
B
B
Sommer
A I
AI
Burhol
P G
PG
D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D004415:Dyspepsia / Q000382:microbiology*; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology; D005756:Gastritis / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications*; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000382:microbiology