title: Impact of microscopic duodenitis on symptomatic response to Helicobacter pylori eradication in functional dyspepsia.
abstract: OBJECTIVE
  There is no consensus regarding the benefit of eradicating Helicobacter pylori (H. pylori) infection in patients with functional dyspepsia (FD). We intended to compare the symptom response to H. pylori eradication in FD patients in presence or absence of microscopic duodenitis (MD).
  
  
  METHODS
  Patients with dyspepsia, normal upper gastrointestinal endoscopy and no psychological comorbidity according to the 12-item General Health Questionnaire underwent duodenal biopsy sampling. Of those, subjects with positive rapid urease test and H. pylori colonization in Wright-Giemsa staining were included in the study and evaluated histologically for presence of MD. All patients received sequential H. pylori eradication therapy and underwent urea breath test 4 weeks after the completion of the treatment to confirm the H. pylori eradication. The severity of dyspepsia was assessed using the Leeds Dyspepsia Questionnaire (LDQ) at baseline, 3rd and 6th months after the H. pylori infection was eradicated.
  
  
  RESULTS
  Thirty seven patients were included in the study [mean age: 34.9 (8.1), 54.05 % female]. MD was observed in 16 (43.2 %) of the subjects. The mean LDQ score in patients with MD decreased from 12.5 (4.1) at baseline to 4.3 (2.1) at 3rd month and 2.6 (1.9) at 6th month. In patients without microscopic duodenitis, the mean LDQ score decreased from 10.6 (5.2) at baseline to 6.8 (4.1) and 6.2 (3.8) at 3rd and 6th months, respectively. The improvement in severity of symptoms in presence of MD was significantly greater than when it was absent (P < 0.001).
  
  
  CONCLUSIONS
  FD patients with MD achieved greater symptomatic response with H. pylori eradication than those without microscopic duodenitis.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Amir Alam Hospital, Tehran University of Medical Sciences, North Sa'adi Street, 13145-784, Tehran, Iran.
authors.forename: Seyed Sina
authors.initials: SS
authors.lastname: Mirbagheri
authors.forename: Seyed Amir
authors.initials: SA
authors.lastname: Mirbagheri
authors.forename: Behnam
authors.initials: B
authors.lastname: Nabavizadeh
authors.forename: Pouya
authors.initials: P
authors.lastname: Entezari
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Ostovaneh
authors.forename: Seyed Mahmood Eshagh
authors.initials: SM
authors.lastname: Hosseini
authors.forename: Nasser
authors.initials: N
authors.lastname: Rakhshani
authors.forename: Hoda
authors.initials: H
authors.lastname: Safa
mesh_terms: D000328:Adult; D001944:Breath Tests; D004382:Duodenitis / Q000150:complications / Q000382:microbiology / Q000473:pathology*; D004415:Dyspepsia; D005260:Female; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016480:Helicobacter pylori / Q000187:drug effects; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008679:Metaplasia; D016896:Treatment Outcome
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