Functional dyspepsia has a good prognosis irrespective of H. pylori status. Long-term follow-up of symptoms after anti H. pylori treatment

Neth J Med. 1999 Aug;55(2):64-70. doi: 10.1016/s0300-2977(99)00059-5.

Abstract

Aim: A prospective study with anti H. pylori therapy was done in patients with functional dyspepsia.

Methods: Inclusion criterion was the absence of any macroscopic abnormality in oesophagus, stomach, and duodenum, irrespective whether H. pylori was present or not. A questionnaire and a symptom score on a five-point Likert scale were used. Antral biopsy specimens were taken for detection of H. pylori. Treatment consisted of omeprazole 20 mg bid and amoxicilline 500 mg tid during 14 days. Patients were followed during 12 months. At follow-up the questionnaire and the symptom score were used. The main endpoint of the study was clinical remission after 1 year of follow-up.

Results: In 1 year 163 patients were included (85 men, 78 women, mean age 47 years, range 21-83 years). H. pylori was present in 91 patients. In the H. pylori positive group 38 patients showed a decrease in IgG antibody titre of more than 50% during follow-up of 3-12 months, 26 showed no change or increase following initial decrease. Overall there was no difference in presence or absence of specific complaints at inclusion and final follow-up. The symptom score decreased significantly in all groups (P < 0.001).

Conclusion: The symptoms of functional dyspepsia improved to a similar extent in both H. pylori positive dyspeptics and the control group. This symptom improvement was irrespective of the change of IgG H. pylori antibodies after therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Amoxicillin / therapeutic use*
  • Anti-Ulcer Agents / therapeutic use*
  • Drug Therapy, Combination
  • Dyspepsia / drug therapy*
  • Dyspepsia / etiology*
  • Female
  • Helicobacter Infections / complications
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / microbiology
  • Helicobacter pylori / drug effects
  • Helicobacter pylori / isolation & purification*
  • Humans
  • Male
  • Middle Aged
  • Omeprazole / therapeutic use*
  • Penicillins / therapeutic use*
  • Prognosis
  • Prospective Studies

Substances

  • Anti-Ulcer Agents
  • Penicillins
  • Amoxicillin
  • Omeprazole