Long-term outcome of functional dyspepsia: effect of Helicobacter pylori infection. A 6- to 7-year follow-up study.
BACKGROUND
Dyspepsia accounts for substantial healthcare costs from medication use and expensive investigations, because most patients with upper abdominal complaints have functional dyspepsia. The role of Helicobacter pylori infection in functional dyspepsia is still controversial. The aim of this study was to investigate the effect of H. pylori infection on the natural history of functional dyspepsia and to evaluate the diagnostic yield of repeat examinations.


METHODS
Unselected patients with dyspepsia in general practice were thoroughly investigated at baseline. Patients with functional dyspepsia were enrolled in this long-term follow-up study. The medical history of each patient was reviewed after 6 to 7 years, and the total number and outcome of repeat investigations recorded. Study patients filled in a dyspepsia questionnaire and were invited for voluntary gastroscopy at the end of follow-up.


RESULTS
Of 205 eligible patients, 201 were finally enrolled in this study (118 H. pylori-positive and 83 H. pylori-negative). No malignancies explaining the patients' symptoms were found during follow-up. Only four cases of peptic ulcer disease were found in H. pylori-infected patients, i.e. an annual incidence of less than 1%. During the follow-up period, H. pylori-positive patients were investigated by endoscopy more often (47%) than H. pylori-negative patients (29%) (P = 0.011) with comparable findings in follow-up examinations.


CONCLUSIONS
Functional dyspepsia is a long-lasting disorder with an excellent prognosis regardless of H. pylori infection.
Heikkinen
M
M
Dept. of Medicine, Kuopio University Hospital, Finland. markku.heikkinen@kuh.fi
Färkkilä
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004415:Dyspepsia / Q000382:microbiology* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D013272:Stomach Diseases / Q000175:diagnosis / Q000382:microbiology