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


METHODS
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).


METHODS
Randomised controlled trials and observational studies conducted worldwide and published between January 1983 and March 1999.


METHODS
Summary odds ratios and summary symptom scores.


RESULTS
23 association studies and 5 eradication trials met the inclusion criteria. In the association studies the summary odds ratio for H pylori infection in patients with non-ulcer dyspepsia was 1.6 (95% confidence interval 1.4 to 1.8). In the eradication trials the summary odds ratio for improvement in dyspeptic symptoms in patients with non-ulcer dyspepsia in whom H pylori was eradicated was 1.9 (1.3 to 2.6).


CONCLUSIONS
Some evidence shows an association between H pylori infection and dyspeptic symptoms in patients referred to gastroenterologists. An improvement in dyspeptic symptoms occurred among patients with non-ulcer dyspepsia in whom H pylori was eradicated.
Jaakkimainen
R L
RL
Institute for Clinical Evaluative Sciences, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada M4N 3M5. liisa.jaakkimainen@ices.on.ca
Boyle
E
E
Tudiver
F
F
D015746:Abdominal Pain / Q000209:etiology; D004415:Dyspepsia / Q000382:microbiology*; D016481:Helicobacter Infections / Q000150:complications* / Q000628:therapy; D016480:Helicobacter pylori; D006801:Humans; D016017:Odds Ratio; D016032:Randomized Controlled Trials as Topic; D012680:Sensitivity and Specificity