Helicobacter pylori infection in non-ulcer dyspeptic and ulcer patients. Determinants and consequences in 'real life'.
BACKGROUND
Infection rates are high in patients with ulcer disease, but even non-ulcer dyspepsia (NUD) patients have Helicobacter pylori infection. The Notodden Helicobacter study is an 'outcome study' of clinical practice in a local hospital. The study may identify factors associated with infection and evaluate whether H. pylori infection predicts symptoms in both ulcer disease and NUD.


METHODS
Base-line results on infection, symptoms, endoscopy, and treatment were registered in 587 ulcer and NUD patients. H. pylori status was assessed with a rapid urease test. Questionnaire data (5-43 months after treatment) give information about symptoms. Regression models to identify H. pylori status were developed.


RESULTS
Ulcer patients (H. pylori +/-) were similar to infected NUD patients. In contrast, uninfected NUD patients were younger, had less severe symptoms, and used less medication than other patients. In NUD, infection rate increased with epigastric pain, male sex, and age.


CONCLUSIONS
From a local hospital's point of view, H. pylori-infected NUD patients are like ulcer patients with regard to symptoms and demographics. The results suggest that H. pylori infection may give dyspeptic symptoms through other mechanisms than ulcer. We propose a division of the NUD group into HINUD (Helicobacter-infected NUD) and NINUD (non-infected NUD).
Thürmer
H L
HL
Medical Dept., Notodden Hospital, Norway.
Flaaten
B
B
Erichsen
K E
KE
Lid
N O
NO
Solheim
S B
SB
D000328:Adult; D000368:Aged; D004415:Dyspepsia / Q000188:drug therapy / Q000382:microbiology*; D005260:Female; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D016480:Helicobacter pylori / Q000302:isolation & purification; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000188:drug therapy / Q000382:microbiology*; D012107:Research Design