There are some benefits for eradicating Helicobacter pylori in patients with non-ulcer dyspepsia.
BACKGROUND
The relationship between Helicobacter pylori infection and non-ulcer dyspepsia is not established.


OBJECTIVE
To determine whether eradication of H. pylori might be of benefit in non-ulcer dyspepsia patients.


METHODS
We randomly assigned 129 H. pylori infected patients with severe epigastric pain, without gastro-oesophageal reflux symptoms, to receive twice daily treatment with 300 mg of ranitidine, 1000 mg of amoxicillin, and 500 mg of clarithromycin for 7 days and 124 such patients to receive identical-appearing placebos.


RESULTS
Treatment was successful (decrease of symptoms at 12 months) in 62% of patients in the active-treatment group and in 60% of the placebo group (N.S.). At 12 months, the rate of eradication of H. pylori was 69% in the active-treatment group and 18% in the placebo group (P < 0.001). Complete relief of symptoms occurred significantly more frequently in patients on the active treatment (43%) than in placebo-treated patients (31%, P=0.048). Within the active-treatment group, therapeutic success was significantly more frequent in the non-infected patients (84% vs. 64%, P=0.04).


CONCLUSIONS
Although eradicating H. pylori is not likely to relieve symptoms in the majority of patients with non-ulcer dyspepsia, a small proportion of H. pylori-infected patients may benefit from eradication treatment.
Bruley Des Varannes
S
S
Department of Hépato-Gastroentérologie, CHU de Nantes, Nantes, France. bruley@easynet.fr
Fléjou
J F
JF
Colin
R
R
Zaïm
M
M
Meunier
A
A
Bidaut-Mazel
C
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology; D005756:Gastritis / Q000188:drug therapy / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000166:cytology / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010406:Penicillins / Q000627:therapeutic use*; D011788:Quality of Life; D011899:Ranitidine / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D010406:Penicillins; D000658:Amoxicillin; D011899:Ranitidine; D017291:Clarithromycin