Abstract
The relationship between Helicobacter pylori gastritis and non-ulcer dyspepsia (NUD; operationally defined as chronic or recurrent pain or discomfort centred in the upper abdomen in the absence of peptic ulceration) has remained in contention for many years. Recently, increasing data have accumulated that support the null hypothesis that there is no true relationship between H. pylori infection and NUD, although there remains healthy scepticism in the scientific community. In this chapter, the epidemiological and pathophysiological data linking gastritis and dyspepsia are reviewed, and the clinical trial evidence is then summarized.
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References
Agreus L, Engstrand L, Svardsudd K, Nyren O, Tibblin G (1995) Helicobacter pylori seropositivity among Swedish adults with and without abdominal symptoms. A population-based epidemiologic study. Scand J Gastroenterol 30:752–757.
Andersen LP, Eisborg L, Justesen T (1988) Campylobacter pylori in peptic ulcer disease. III. Symptoms and paraclinical and epidemiological findings. Scand J Gastroenterol 23:344–350.
Armstrong D (1996) Helicobacter pylori infection and dyspepsia. Scand J Gastroenterol 31 [Suppl215]:38–47.
Barnett JL, Behler EM, Appelman HD, Etta GH (1989) Campylobacter pylori is not associated with gastroparesis. Dig Dis Sci 34:1677–1680.
Bernersen B, Johnsen R, Bostad L, Straume B, Sommer A-I, Burhol PG (1992) Is Helicobacter pylori the cause of dyspepsia? BMJ 304:1276–1279.
Bernersen B, Johnsen R, Straume B, Burhol PG, Jenssen TG, Stakkevold PA (1990) Towards a true prevalence of peptic ulcer: the Sorreisa gastrointestinal disorder study. Gut 31(9):989–992.
Blum AL, Talley NJ, O’Morain C et al. Does eradication of H. pylori cure dyspeptic symptoms in patients with functional dyspepsia 12 months after cessation of treatment? Digestion 1998; 59 (Suppl 3): A2073.
Borsch G, Schmidt G, Wegner M, Sandmann M, Adamek R, Leverkus F et al. (1988) Campylobacter pylori: prospective analysis of clinical and histological factors associated with colonization of the upper gastrointestinal tract. Eur J Clin Invest 18:133–138.
Caballero-Plasencia AM, Muros-Navarro MC, Martin-Ruiz JL et al. (1995) Dyspeptic symptoms and gastric emptying of solids in patients with functional dyspepsia. Scand J Gastroenterol 30:745–751.
Caldwell SH, Valenzeula G, Marshall BJ et al. (1992) Helicobacter pylori infection and gastric emptying of solids in humans. J Gastrointest Mot 4:113–117.
Ching CK, Wong BCY, Kwok E, Ong L, Covacci A, Lam SK (1996) Prevalence of CagA-bearing strains detected by the anti-CagA assay in patients with peptic ulcer disease and in controls. Am J Gastroenterol 91:949–953.
Collins JSA, Hamilton PW, Watt PCH, Sloan JM, Love AHG (1989) Superficial gastritis and Campylobacter pylori in dyspeptic patients - a quantitative study using computer-linked image analysis. J Pathol 158:303–310.
Collins JSA, Knill-Jones RP, Sloan JM et al. (1991) A comparison of symptoms between non-ulcer dyspepsia patients positive and negative for Helicobacter pylori. Ulster Med J 60:21–27.
Crabtree JE, Covacci A, Farmery SM, Xiang Z, Tompkins DS, Perry S et al. (1995) Helicobacter pylori induces interleukin-8 expression in gastric epithelial cells in association with Cag A positive pheno-type. J Clin Pathol 48:41–45.
Crowe SE, Alvarez L, Dytoc M et al. (1995) Expression of interleukin 8 and CD54 by human gastric epithelium Helicobacter pylori infection in vitro. Gastroenterology 108:65–74.
Cucchiara S, Salvia G, Az-Zeqeh N, D’Anniento F, DePetra MR, Rapagiolo S, Campanozzi A, Emiliano M (1996) Helicobacter pylori gastritis and non-ulcer dyspepsia in childhood. Efficacy of one-week triple antimicrobial therapy in eradicating the organism. Ital J Gastroenterol 28:430–435.
Cupella F, Alessio I, Intropido L, Pozzi V, Einaudi E, Possi U (1991) Dyspepsia ed infezione do Helicobacter pylori. Studio su una popolazione di lavatori. G Ital Med Lav 13:81–84.
Deltenre M, Nyst J-F, Jonas C, Glupczynski Y, Deprez C, Burette A (1989) Donnees cliniques, endo-scopiques et histologiques chez 1100 patients dont 574 colonises par Campylobacter pylori. Gastroenterol Clin Biol 13:89–95B.
Eidt S, Stolte M (1993) Prevalence of lymphoid follicles and aggregates in Helicobacter pylori gastritis in antral and body mucosa. J Clin Pathol 46:832–835.
El Omar E, Penman ID, Ardili JES, McColl KEL (1995) A substantial proportion of non-ulcer dyspepsia patients have the same abnormality of acid secretion as duodenal ulcer patients. Gut. 36:534–538.
Genta RM, Hamner HW, Graham DY (1993) Gastric lymphoid follicles in Helicobacter pylori infection: frequency, distribution, and response to triple therapy. Hum Pathol 26:1057–1065.
Gilja OH, Hausken T, Wilhelmsen I, Berstad A (1996) Impaired accommodation of proximal stomach to a meal in functional dyspepsia. Dig Dis Sci 41:689–696.
Gill HH, Desai HG, Majmudar P, Mehta PR, Prabhu SR (1993) Epidemiology of Helicobacter pylori: the Indian scenario. Ind J Gastroenterol 12:9–11.
Gilvarry J, Buckley M, Beattie, Hamilton H, O’Morain C (1997) Eradication of Helicobacter pylori affects symptoms in non-ulcer dyspepsia. Scand J Gastroenterol 32:535–540.
Goh KL, Parasakthi N, Peh SC, Wong NW, Lo YL, Puthucheary SD (1991) Helicobacter pylori infection and non-ulcer dyspepsia: the effect of treatment with colloidal bismuth subcitrate. Scand J Gastroenterol 26:1123–1131.
Greenberg PD, Cello JP (1996) Prospective, double-blind treatment of Helicobacter pylori in patients with non-ulcer dyspepsia (abstract). Gastroenterology 110:108A.
Greenberg RE, Bank S (1990) The prevalence of Helicobacter pylori in nonulcer dyspepsia. Importance of stratification according to age. Arch Intern Med 150:2053–2055.
Gurre J, Berthe Y, Chaussade S, Merite F, Gaudric M, Tulliez M, Deslignieres S, Zone A (1989) Has Campylobacter pylori gastritis a specific clinical symptomatology? Klin Wochenschr 67 [SupplXVIII]:25.
Gutierrez D, Sierra F, Gomez MC, Camargo H (1988) Campylobacter pylori in chronic environmental gastritis and duodenal ulcer patients. Gastroenterology 94:A163.
Hansen IM, Axelsson CK, Lundborg CJ (1988) Distribution of Campylobacter pylori in dyspeptic and non-dyspeptic gastroenterologie patients. Dan Med Bull 35:2825.
Haruma K, Sumii K, Okamato S, Yoshiraha M, Tari A et al. (1992) Helicobacter pylori causes low antral somatostatin content: pathogenesis of inappropriate hypergastrinaemia. Gastroenterology A80.
Holtmann G, Goebell H, Holtmann M, Talley NJ (1994) Dyspepsia in healthy blood donors: pattern of symptoms and association with Helicobacter pylori. Dig Dis Sci 39:1090–1098.
Holtmann G, Talley NJ, Mitchell H, Hazell S Antibody response to specific H. pylori antigens in-functional dyspepsia, duodenal ulcer disease, and health. Am J Gastroenterol 1998; 93:1222–7
Holtmann G, Talley NJ, Goebell H (1996) Association between H. pylori, duodenal mechanosensory thresholds, and small intestinal motility in chronic unexplained dyspepsia. Dig Dis Sci 41:1285–1291.
Hovelius B, Anderson SI, Hagander B, Mostad S, Reimers P, Sperlich E et al. (1994) Dyspepsia in general practice: history and symptoms in relation to Helicobacter pylori serum antibodies. Scand J Gastroenterol 29:506–510.
Inouye H, Yamamoto I, Tanida N (1989) Campylobacter pylori in Japan: bacteriological features and prevalence in healthy subjects and patients with gastroduodenal disorders. Gastroenterol Jpn 24:494–504.
Jeena CP, Simjee AE, Pettengall KE et al. (1988) Comparison of symptoms in Campylobacter pylori positive and negative patients presenting with dyspepsia for upper gastrointestinal endoscopy (abstract). S Afr Med J 73:659.
Johnsen R, Bernersen B, Straume B, Forder OH, Bostad L, Burhol PG (1991) Prevalences of endoscopic and histological findings in subjects with and without dyspepsia. BMJ 302:749–752.
Jorde R, Bostad L, Burhol PG (1986) Asymptomatic gastric ulcer: a follow-up study in patients with previous gastric ulcer disease. Lancet 1:119–121.
Kaneko H, Mitsuma T, Uchida K, Furusawa A, Morise K (1993) Immunoreactive-somatostatin, substance p, and calcitonin gene-related peptide concentration of the human gastric mucosa in patients with nonulcer dyspepsia and peptic ulcer disease. Am J Gastroenterol 88:898–904.
Katelaris PH, Tippett GHK, Norbu P, Lowe DG, Brennan R, Farthing MJG (1992) Dyspepsia, Helicobacter pylori and peptic ulcer in a randomly selected population in India. Gut 33:1462–1466.
Kemmer TP, Domingo-Munoz JE, Klingel H, Zemmler T, Kuhn K, Malfertheiner P (1994) The association between non-ulcer dyspepsia and Helicobacter pylori infection. Eur J Gastroenterol Hepatol 6:571–577.
Klauser AG, Schindlbeck NE, Muller Lissner SA (1990) Symptoms in gastro-oesophageal reflux disease. Lancet 335:295–298.
Knill-Jones RP (1991) Geographical differences in the prevalence of dyspepsia. Scand J Gastroenterol 26 [Suppl 182]: 17–24.
Labenz J, Blum AL, Bayerdorffer E, Meining A, Stolte M, Borsch G (1997) Curing Helicobacter pylori infection in patients with duodenal ulcer may provoke reflux esophagitis. Gastroenterology 112:1442–1447.
Laheij RJF, Jansen JBMJ, Van Da Lisnok EH, Severens JL, Verbeek ALM (1996) Review article: symptom improvement through eradication of Helicobacter pylori in patients with non-ulcer dyspepsia. Aliment Pharmacol Ther 10:843–850.
Lai ST, Fung KP, Ng FH, Lee KC (1996) A quantitative analysis of symptoms of non-ulcer dyspepsia as related to age, pathology and Helicobacter pylori infection. Scand J Gastroenterol 31:1078–1082.
Lambert JR, Dunn K, Borromeo M, Korman MG, Hansky J (1989) Campylobacter pylori — a role in non-ulcer dyspepsia? Scand J Gastroenterol 24 [Suppl 160]: 7–13.
Lazzaroni M, Bargigga S, Sangaletti O, Maconi G, Boldorini M, Bianchi Aporro G (1996) Eradication of Helicobacter pylori and long-term outcome of functional dyspepsia. A clinical endoscopic study. Dig Dis Sci 41:1589–1594.
Levi S, Beardshall K, Swift I et al. (1989) Antral Helicobacter pylori, hypergastrinaemia and duodenal ulcer: effect of eradication the organism. Br Med J 299:1504–1505.
Loffeld RJLF, Potters HVPJ, Arends JW, Stobberingh E, Flendrig JA (1988) Campylobacter associated gastritis in patients with non-ulcer dyspepsia. J Clin Pathol 41:85–88.
Marshall BJ, Warren JR (1984) Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet 1:1311–1315.
McColl KEL, Murray LS, El-Omar E et al. (1998) UK-MRC trial of H. pylori eradication therapy for non-ulcer dyspepsia. Gut 42 (Suppl):A3.
Mearin F, de Ribot X, Balboa A et al. (1995) Does Helicobacter pylori infection increase gastric sensitivity in functional dyspepsia? Gut 37:47–51.
Megraud F, Brassens-Rabbe MP, Denis F, Belbouri A, Hoa DQ (1989) Seroepidemiology of Campylobacter pylori infection in various populations. J Clin Micro 27:1870–1873.
Minocha A, Mokshagundam S, Gallo S, Singh Rahal P (1994) Alteration in upper gastrointestinal motility in Helicobacter pylori-positive nonulcer dyspepsia. Am J Gastroenterol 89:1797–1800.
Moore SC, Malagelada J-R, Shorter RG, Zinsmeister AR (1986) Interrelationships among gastric mucosal morphology, secretion, and motility in peptic ulcer disease. Dig Dis Sci 31:673–684.
Mukhopadhyay DK, Tandon RK, Dasarathy S, Mathur M, Wali JP (1992) A study of Helicobacter pylori in north Indian subjects with non-ulcer dyspepsia. Ind J Gastroenterol 11:76–79.
Murakami K, Fucoda T, Shiota K, Ito A, Fujiyama K, Kodama R, Kawasaki Y, Kubota T, Nasu M (1995) Influence of infection and the effect of its eradication on gastric emptying in non-ulcerative dyspepsia. Eur J Gastroenterol Hepatol LS93–S97.
Nandurkar S, Talley NJ, Xia HH-X, Mitchell H, Hazel S, Jones M (1998) Dyspepsia in the community is linked to smoking and aspirin use but not to Helicobacter pylori. Infection. Arch Intern Med 158:1427–33.
Noach LA, Bosma NM, Jansen J, Hock FJ, van Deventer SJH, Tytgat GNT (1994) Mucosal tumour necrosis factor-a, interleukin-lb, and interleukin-8 production in patients with Helicobacter pylori infection. Scand J Gastroenterol 29:425–429.
O’Morain CA, Buckley M (1993) H pylori in asymptomatic people. In: Hunt RH, Tytgat GNJ (eds) Helicobacter pylori: basic mechanisms to clinical cure. Kluwer Academic, Dordecht, pp 423–420.
Pettross CW, Appleman MD, Cohen H, Valenzuela JE, Chandrasoma P, Laine LA (1988) Prevalence of Campylobacter pylori and association with antral mucosal histology in subjects with and without upper gastrointestinal symptoms. Dig Dis Sci 33:649–653.
Pieramico O, Ditshuneit H, Malfertheiner P (1983) Gastrointestinal motility in patients with non-ulcer dyspepsia: a role of Helicobacter pylori infection? Am J Gastroenterol 88:364–368.
Pretolani S, Bonvicini F, Brocchi E, Baraldini M, Cilla D, Baldinelli S, Bazzocchi E, Pasini P, Gasbarrini G (1994) Nonulcer dyspepsia and Helicobacter pylori: effect of eradication on symptoms and gastritis. In: Gasbarrini G, Pretolani S (eds) Basic and clinical aspects of helicobacter pylori infection. Springer, Berlin Heidelberg New York.
Prewett E J, Smith JFL, Nivokolo CU, Hudson M, Sawyerr AM, Pounder RE (1991) Eradication of Helicobacter pylori associated 24 hour hypergastrinaemia: a prospective study in healthy subjects. Aliment Pharmacol Ther 5:283–290.
Qvist N, Ramussen L, Axelsson CK (1994) Associated gastritis and dyspepsia. The influence on migrating motor complexes. Scand J Gastroenterol 29:133–137.
Rathbone BJ, Wyatt J, Heatley RV (1988) Symptomatology in C pylori-positive and - negative non-ulcer dyspepsia. Gut 29:A1473.
Rauws EAJ, Langenberg W, Houthoff HJ, Zanen HC, Tytgat GNJ (1988) Campylobacter pylori disassociated chronic active antral gastritis. A prospective study of its prevalence and the effects of antibacterial and antiulcer treatment. Gastroenterology 94:33–40.
Rokkas T, Pursey C, Uzoechina E et al. (1987) Campylobacter pylori and non-ulcer dyspepsia. Am J Gastroenterol 82:1149–1152.
Schlemper RJ, van der Werf SDJ, Vandenbroucke JP, Biemond I, Lamers CBHW (1995) Nonulcer dyspepsia in a Dutch working population and Helicobacter pylori. Arch Intern Med 155:82–87.
Schubert TT, Schubert AB, Ma CK (1992) Symptoms, gastritis, and Helicobacter pylori in patients referred for endoscopy. Gastrointest Endose 38:357–360.
Schutze K, Hentschel E, Hirschl AM (1996) Clarithromycin or amoxycillin plus high-dose ranitidine in the treatment of Helicobacter pylori-positive functional dyspepsia. Eur J Gastroenterol Hepatol 8:41–46.
Sheu B-S, Lin C-Y, Lin X-Z, Shiesh S-C, Yang H-B, Chen C-Y (1996) Long-term outcome of triple therapy in H pylori-related nonulcer dyspepsia: a prospective controlled assessment. Am J Gastroenterol 91:441–447.
Sobala GM, Dixon MF, Axon ATR (1990) Symptomatology of Helicobacter pylori-associated dyspepsia. Eur J Gastroenterol Hepatol 2:445–449.
Stanghellini V, Ghidini C, Ricci Maccarini M et al. (1992) Fasting and postprandial gastrointestinal motility in ulcer and non-ulcer dyspepsia. Gut 33:184–190.
Strauss RM, Wang TC, Kelsey PB, Compton CC, Ferraro M-J, Perez-Perez G et al. (1990) Association of Helicobacter pylori infection with dyspeptic symptoms in patients undergoing gastroduodenoscopy. Am J Med 89:464–469.
Talley NJ (1994a) A critique of therapeutic trials in Helicobacter pylori-positive functional dyspepsia. Gastroenterology 106:1174–1183.
Talley NJ (1994b) Why do functional gastrointestinal disorders come and go? Dig Dis Sci 39:673–677.
Talley NJ, Colin-Jones D, Koch KL, Koch M, Nyren O, Stanghellini V (1991) Functional dyspepsia: a classification with guidelines for diagnosis and management. Gastroenterol Int 4:145–160.
Talley NJ, Zinsmeister AR, Schleck CD, Melton LJ (1994) Smoking, alcohol, and analgesics in dyspepsia and among dyspepsia subgroups: lack of an association in a community. Gut 35:619–624.
Talley NJ, Janssens J, Lauritsen K et al. Long term follow-up of patients with non-ulcer dyspepsia after Helicobacter pylori eradication. A randomized double-blind placebo-controlled trial. Gastroenterology 1998; 114:A305.
The European Helicobacter pylori Study Group (1997) Current European concepts in the management of the Helicobacter pylori infection. The Maastricht Consensus Report. Gut 40: (in press).
Toukan AU, Kamal MF, Amr SS, Arnaout MA, Abu-Romiyeh AS (1985) Gastroduodenal inflammation in patients with non-ulcer dyspepsia: a controlled endoscopic and morphometric study. Dig Dis Sci 30:313–320.
Trespi E, Broglia F, Villani L, Luinetti O, Fiocca R, Solcia E (1994) Distinct profiles of gastritis in dyspepsia subgroups. Their different clinical responses to gastritis healing after Helicobacter pylori eradication. Scand J Gastroenterol 29:884–888.
Tucci A, Corinaldesi R, Stanghellini V, Tosetti C di Febo G, Páparo F, et al. (1992) Helicobacter pylori infection and gastric function in patients with chronic idiopathic dyspepsia. Gastroenterology 103:768–774.
Tytgat GNJ, Noach LA, Rauws EAJ (1991) Is gastroduodenitis a cause of chronic dyspepsia? Scand J Gastroenterol 26 [Suppl 182]:33–39.
Vaira D, Holton J, Osborn J et al. (1990) Endoscopy in dyspeptic patients: Is gastric mucosal biopsy useful? Am J Gastroenterol 85:701–704.
Valle J, Seppala K, Sipponen O, Kosunen T (1991) Disappearance of gastritis after eradication of Helicobacter pylori: a morphometric study. Scand J Gastroenterol 26:1057–1065.
Vedhuyzen van Zanten, Malatjilian D, Tanton R, Leddin D, Hunt RH, Blanchard W et al. (1995) The effect of eradication of H pylori on symptoms of nonulcer dyspepsia: a randomized double-blind placebo controlled trial. Gastroenterology 108:A250.
Waldron B, Cullen PT, Kumar R et al. (1991) Evidence for hypomotility in non-ulcer dyspepsia: a prospective multifactorial study. Gut 32:246–251.
Wegner M, Borsch G, Schaffstein J, Schulze-Flake C, Mai U, Leverkus F (1988) Are dyspeptic symptoms in patients with Campylobacter pylori-associated type B gastritis linked to delayed gastric emptying?.
Am J Gastroenterol 83:737–740.
Wilhelmsen I, Tangen Haug T, Sipponen P, Berstad A (1994) Helicobacter pylori in functional dyspepsia and normal controls. Scand J Gastroenterol 29:522–527.
Yates S, Barnett C, Peterson WL (1992) Enteric coated charcoal as a means of blinding studies comparing bismuth and H2-receptor antagonist. Am J Gastroenterol 87:981–984.
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Kalantar, J., Eslick, G.D., Talley, N.J. (1999). Chronic Gastritis and Nonulcer Dyspepsia. In: Westblom, T.U., Czinn, S.J., Nedrud, J.G. (eds) Gastroduodenal Disease and Helicobacter pylori . Current Topics in Microbiology and Immunology, vol 241. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60013-5_3
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