title: Effect of pantoprazole and Helicobacter pylori therapy on uninvestigated dyspeptic patients.
abstract: OBJECTIVE
  This study aimed to test the efficacy of empirical proton pump inhibitor use and Helicobacter pylori therapy for uninvestigated dyspepsia in a population with a high prevalence of H. pylori.
  
  
  METHODS
  The study had a two-stage design. In the first stage, the efficacy of 4-week pantoprazole treatment was compared with placebo in patients with uninvestigated dyspepsia. In the second stage, the efficacies of 2-week treatment with pantoprazole in H. pylori-negative patients and H. pylori eradication therapy (pantoprazole + amoxicillin + clarithromycin) in H. pylori-positive patients were compared. The primary endpoint was sufficient overall symptom relief (Global Overall Symptom score ≤2; no or minimal symptoms) at the end of treatment.
  
  
  RESULTS
  In the first stage, sufficient overall symptom relief was achieved by 25.2% of patients in the pantoprazole group and 15.5% of patients in the placebo group, a difference that was not statistically significant (p=0.06). In the second stage, the rate of sufficient overall symptom relief was higher in the H. pylori therapy group than in the pantoprazole group (37.1% vs. 23.4%; p=0.02). After untreated follow-up, sufficient overall symptom relief remained significantly higher in the H. pylori therapy group than in the pantoprazole group (39.7% vs. 18%; p<0.001). Almost all patients receiving pantoprazole experienced symptom relapse after treatment.
  
  
  CONCLUSIONS
  This study validated the use of a test-and-treat strategy against H. pylori in uninvestigated dyspepsia, which may be an advisable treatment approach for uninvestigated dyspeptic patients in countries with a high prevalence of H. pylori.
authors.affiliation: Department of Gastroenterology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey. babbaysal@gmail.com.
authors.forename: Birol
authors.initials: B
authors.lastname: Baysal
authors.forename: Hakan
authors.initials: H
authors.lastname: Şentürk
authors.forename: Omar
authors.initials: O
authors.lastname: Masri
authors.forename: Mukaddes
authors.initials: M
authors.lastname: Tozlu
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Kayar
authors.forename: Elif
authors.initials: E
authors.lastname: Arabacı
authors.forename: Ömer
authors.initials: Ö
authors.lastname: Uysal
authors.forename: Mehmet Sait
authors.initials: MS
authors.lastname: Buğdacı
authors.forename: Ali Tüzün
authors.initials: AT
authors.lastname: İnce
mesh_terms: D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000627:therapeutic use*; D000328:Adult; 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 / Q000379:methods; D004415:Dyspepsia / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077402:Pantoprazole; D012008:Recurrence; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D000658:Amoxicillin; D000077402:Pantoprazole; D017291:Clarithromycin