title: Treatment of Helicobacter pylori in functional dyspepsia resistant to conventional management: a double blind randomised trial with a six month follow up.
abstract: BACKGROUND
  Previous studies on the treatment of Helicobacter pylori infection in functional dyspepsia have shown little, if any, effect on dyspeptic symptoms. However, whether such treatment might be of benefit in patients resistant to acid inhibitors has not been formally tested.
  
  
  OBJECTIVE
  The present study investigated the effect of H pylori treatment in patients with functional dyspepsia resistant to conventional treatment.
  
  
  METHODS
  A total of 181 H pylori positive patients with chronic functional dyspepsia who had not responded to a one week antacid run-in and two week double blind antisecretory or placebo treatment were included.
  
  
  METHODS
  Patients were randomised to two weeks of treatment with omeprazole 40 mg twice daily combined with amoxicillin 1 g twice daily or omeprazole 20 mg once daily alone. The primary outcome variable ("response") was defined as no need for further therapy or investigations for dyspeptic symptoms 4-6 months after treatment.
  
  
  RESULTS
  H pylori infection was healed in 10% of patients after omeprazole and in 52% after omeprazole plus amoxicillin. The respective "response" rates were 66% and 62% (NS). H pylori treatment and cure of H pylori infection had no effect on complete resolution of all dyspeptic symptoms, individual symptoms, or various aspects of quality of life.
  
  
  CONCLUSIONS
  In functional dyspepsia, H pylori treatment and cure of H pylori are no more effective for symptoms over six months than short term acid inhibition. These results do not support treatment of H pylori in functional dyspepsia.
authors.affiliation: Division of Gastroenterology, Department of Medicine, Triemli Hospital, Zurich, Switzerland. hrkoelz@hin.ch
authors.forename: H R
authors.initials: HR
authors.lastname: Koelz
authors.forename: R
authors.initials: R
authors.lastname: Arnold
authors.forename: M
authors.initials: M
authors.lastname: Stolte
authors.forename: M
authors.initials: M
authors.lastname: Fischer
authors.forename: A L
authors.initials: AL
authors.lastname: Blum
mesh_terms: D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009853:Omeprazole / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use*; D054328:Proton Pump Inhibitors; D011788:Quality of Life; D017211:Treatment Failure
chemical_list: D000897:Anti-Ulcer Agents; D010406:Penicillins; D054328:Proton Pump Inhibitors; D000658:Amoxicillin; D009853:Omeprazole