title: Clinical trial: prolonged beneficial effect of Helicobacter pylori eradication on dyspepsia consultations - the Bristol Helicobacter Project.
abstract: BACKGROUND
  Chronic infection of the stomach with Helicobacter pylori is widespread throughout the world and is the major cause of peptic ulcer disease and gastric cancer. Short-term benefit results from community programmes to eradicate the infection, but there is little information on cumulative long-term benefit.
  
  
  OBJECTIVE
  To determine whether a community programme of screening for and eradication of H. pylori infection produces further benefit after an initial 2-year period, as judged by a reduction in GP consultations for dyspepsia.
  
  
  METHODS
  A total of 1517 people aged 20-59 years, who were registered with seven general practices in Frenchay Health District, Bristol, had a positive (13)C-urea breath test for H. pylori infection and were entered into a randomized double-blind trial of H. pylori eradication therapy. After 2 years, we found a 35% reduction in GP consultations for dyspepsia (previously reported). In this extension to the study, we analysed dyspepsia consultations between two and 7 years after treatment.
  
  
  RESULTS
  Between two and 7 years after treatment, 81/764 (10.6%) of participants randomized to receive active treatment consulted for dyspepsia, compared with 106/753 (14.1%) of those who received placebo, a 25% reduction, odds ratio 0.84 (0.71, 1.00), P = 0.042.
  
  
  CONCLUSIONS
  Eradication of H. pylori infection in the community gives cumulative long-term benefit, with a continued reduction in the development of dyspepsia severe enough to require a consultation with a general practitioner up to at least 7 years. The cost savings resulting from this aspect of a community H. pylori eradication programme, in addition to the other theoretical benefits, make such programmes worthy of serious consideration, particularly in populations with a high prevalence of H. pylori infection.
authors.affiliation: Frenchay Hospital, North Bristol Healthcare Trust, UK. richard.harvey1@virgin.net
authors.forename: R F
authors.initials: RF
authors.lastname: Harvey
authors.forename: J A
authors.initials: JA
authors.lastname: Lane
authors.forename: P
authors.initials: P
authors.lastname: Nair
authors.forename: M
authors.initials: M
authors.lastname: Egger
authors.forename: I
authors.initials: I
authors.lastname: Harvey
authors.forename: J
authors.initials: J
authors.lastname: Donovan
authors.forename: L
authors.initials: L
authors.lastname: Murray
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004311:Double-Blind Method; D004415:Dyspepsia / Q000175:diagnosis* / Q000191:economics / Q000517:prevention & control*; D005260:Female; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000191:economics; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics; D008875:Middle Aged; D055815:Young Adult