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Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia: a randomized, double-blind study

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Abstract

Background

This randomized, double-blind study compared the efficacy of Helicobacter pylori eradication against prokinetics in H. pylori-infected functional dyspepsia patients.

Methods

Patients with moderately severe or severe dyspepsia fulfilling the Rome II criteria were randomized to either H. pylori eradication for 1 week and 6 weeks of placebo prokinetics or 6 weeks of prokinetics and placebo H. pylori eradication in the first week. Symptoms were assessed at baseline and at 6 and 12 months using the Glasgow Dyspepsia Severity Score (GDSS). Global response to treatment was assessed at 12 months.

Results

Altogether 130 patients were enrolled (H. pylori eradication, 71; prokinetics, 59). The mean baseline GDSS was 9.3 for the H. pylori eradication group and 8.9 for the prokinetic group. At 6 months, the score was 3.6 and 4.1, respectively, and it remained at 3.5 and 3.8, respectively, at 12 months. With H. pylori eradication, 31.0% had complete symptom resolution (GDSS 0 or 1) at 12 months compared with 23.7% with prokinetics (a nonsignificant difference). At 12 months, global symptomatic improvement was seen in 62.0% of the H. pylori eradication group compared with 67.8% of the prokinetics group.

Conclusions

Both H. pylori eradication and prokinetic therapy resulted in symptom improvement in two-thirds of dyspeptic patients at 1 year. More patients tended to achieve complete symptom relief with H. pylori eradication.

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References

  1. L Agreus (2002) ArticleTitleNatural history of dyspepsia Gut 50 IssueIDSuppl IV iv2–9 10.1136/gut.50.suppl_4.iv2 Occurrence Handle10.1136/gut.50.suppl_4.iv2 Occurrence Handle11953337

    Article  PubMed  Google Scholar 

  2. N Talley M Silverstein L Agreus O Nyren A Sonnenberg G Holtmann (1998) ArticleTitleAGA technical review: evaluation of dyspepsia Gastroenterology 114 582–95 10.1016/S0016-5085(98)70542-6 Occurrence Handle10.1016/S0016-5085(98)70542-6 Occurrence Handle1:STN:280:DyaK1c7ls1Kltg%3D%3D Occurrence Handle9496950

    Article  CAS  PubMed  Google Scholar 

  3. NJ Talley V Stanghellini RC Heading KL Koch JR Malagelada GNJ Tytgat (1999) ArticleTitleFunctional gastroduodenal disorders Gut 45 IssueIDSuppl II 37–42

    Google Scholar 

  4. RS Fisher HP Parkman (1998) ArticleTitleManagement of non-ulcer dyspepsia N Eng J Med 339 1376–81 10.1056/NEJM199811053391907 Occurrence Handle10.1056/NEJM199811053391907 Occurrence Handle1:STN:280:DyaK1M%2Fgs1Kjsg%3D%3D

    Article  CAS  Google Scholar 

  5. D Armstrong (1996) ArticleTitleHelicobacter pylori infection and dyspepsia Scand J Gastroenterol 31 IssueIDSuppl II 38–47 Occurrence Handle10.3109/00365529609094532

    Article  Google Scholar 

  6. A Minocha S Mokshagundam SH Gallo PS Rahal (1994) ArticleTitleAlterations in upper gastrointestinal motility in Helicobacter pylori-positive non-ulcer dyspepsia Am J Gastroenterol 89 1797–800 Occurrence Handle1:STN:280:DyaK2M%2FivFWrsA%3D%3D Occurrence Handle7942670

    CAS  PubMed  Google Scholar 

  7. H Miyaji T Azuma S Ito Y Abe H Ono H Suto et al. (1999) ArticleTitleThe effect of Helicobacter pylori eradication therapy on gastric antral myoelectrical activity and gastric emptying in patients with non-ulcer dyspepsia Aliment Pharmacol Ther 13 1473–80 10.1046/j.1365-2036.1999.00634.x Occurrence Handle10.1046/j.1365-2036.1999.00634.x Occurrence Handle1:STN:280:DC%2BD3c%2FjvF2luw%3D%3D Occurrence Handle10571604

    Article  CAS  PubMed  Google Scholar 

  8. Moayyedi P, Soo S, Deeks J, Delaney B, Harris A, Innes M, et al. Eradication of Helicobacter pylori for non-ulcer dyspepsia. Cochrane Database Syst Rev 2005 Jan 25;(1):CD002096

  9. Moayyedi P, Soo S, Deeks J, Delaney B, Innes M, Forman D. Eradication of Helicobacter pylori for non-ulcer dyspepsia. Cochrane Database Syst Rev 2004 Oct 18;(4):CD001960

  10. EM El-Omar S Banerjee A Wirz KE McColl (1996) ArticleTitleThe Glasgow Dyspepsia Severity Score—a tool for the global measurement of dyspepsia Eur J Gastroenterol Hepatol 8 967–71 Occurrence Handle10.1097/00042737-199610000-00006 Occurrence Handle1:STN:280:DyaK2s%2FosVaitA%3D%3D Occurrence Handle8930560

    Article  CAS  PubMed  Google Scholar 

  11. K McColl L Murray E El-Omar A Dickson A El-Nujumi A Wirz et al. (1998) ArticleTitleSymptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia N Engl J Med 339 1869–74 10.1056/NEJM199812243392601 Occurrence Handle10.1056/NEJM199812243392601 Occurrence Handle1:STN:280:DyaK1M%2FmslWmsg%3D%3D Occurrence Handle9862941

    Article  CAS  PubMed  Google Scholar 

  12. S Bruley des Varannes JF Flejou R Colin M Zaim A Meunier C Bidaut-Mazel (2001) ArticleTitleThere are some benefits for eradicating Helicobacter pylori in patients with non-ulcer dyspepsia Aliment Pharmacol Ther 15 1177–85 10.1046/j.1365-2036.2001.01014.x Occurrence Handle10.1046/j.1365-2036.2001.01014.x Occurrence Handle1:STN:280:DC%2BD3MvktVOntA%3D%3D Occurrence Handle11472320

    Article  CAS  PubMed  Google Scholar 

  13. P Malfertheiner J Mossner W Fischbach P Layer A Leodolter M Stolte et al. (2003) ArticleTitleHelicobacter pylori eradication is beneficial in the treatment of functional dyspepsia Aliment Pharmacol Ther 18 615–25 10.1046/j.1365-2036.2003.01695.x Occurrence Handle10.1046/j.1365-2036.2003.01695.x Occurrence Handle1:CAS:528:DC%2BD3sXos1Clu7k%3D Occurrence Handle12969088

    Article  CAS  PubMed  Google Scholar 

  14. NJ Talley J Janssens K Lauritsen I Racz E Bolling-Sternevald (1999) ArticleTitleEradication of Helicobacter pylori in functional dyspepsia: randomized double blind placebo controlled trial with 12 months follow up. The Optimal Regimen Cures Helicobacter Induced Dyspepsia (ORCHID) Study Group BMJ 318 833–7 Occurrence Handle1:CAS:528:DyaK1MXisVaht7s%3D Occurrence Handle10092259

    CAS  PubMed  Google Scholar 

  15. AL Blum NJ Talley C O’Morain SV van Zanten J Labenz M Stolte et al. (1998) ArticleTitleLack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia. Omeprazole plus Clarithromycin and Amoxicillin Effect One Year after Treatment (OCAY) Study Group N Engl J Med 339 1875–81 10.1056/NEJM199812243392602 Occurrence Handle10.1056/NEJM199812243392602 Occurrence Handle1:STN:280:DyaK1M%2FmslWmsw%3D%3D Occurrence Handle9862942

    Article  CAS  PubMed  Google Scholar 

  16. P Sawant HS Das N Desai S Kalokhe S Patil (2004) ArticleTitleComparative evaluation of the efficacy and tolerability of itopride hydrochloride and domperidone in patients with non-ulcer dyspepsia J Assoc Physicians India 52 626–8 Occurrence Handle15847356

    PubMed  Google Scholar 

  17. DN Amarapurkar P Rane (2004) ArticleTitleRandomised, double-blind, comparative study to evaluate the efficacy and safety of Ganaton (itopride hydrochloride) and mosapride citrate in the management of functional dyspepsia J Indian Med Assoc 102 735–7 Occurrence Handle15871365

    PubMed  Google Scholar 

  18. NJ Talley N Vakil ED Ballard Suffix2nd MB Fennerty (1999) ArticleTitleAbsence of benefit of eradicating Helicobacter pylori in patients with non-ulcer dyspepsia N Engl J Med 341 1106–11 10.1056/NEJM199910073411502 Occurrence Handle10.1056/NEJM199910073411502 Occurrence Handle1:STN:280:DyaK1Mvis1Grtg%3D%3D Occurrence Handle10511608

    Article  CAS  PubMed  Google Scholar 

  19. PI Hsu KH Lai HH Tseng GH Lo CC Lo CK Lin et al. (2001) ArticleTitleEradication of Helicobacter pylori prevents ulcer development in patients with ulcer-like functional dyspepsia Aliment Pharmacol Ther 15 195–201 10.1046/j.1365-2036.2001.00903.x Occurrence Handle10.1046/j.1365-2036.2001.00903.x Occurrence Handle1:STN:280:DC%2BD3M7isF2guw%3D%3D Occurrence Handle11148437

    Article  CAS  PubMed  Google Scholar 

  20. NJ Talley K Lauritsen (2002) ArticleTitleThe potential role of acid suppression in functional dyspepsia: the BOND, OPERA, PILOT, and ENCORE studies Gut 50 IssueIDSuppl IV 36–41

    Google Scholar 

  21. A Raghunath AP Hungin D Wooff S Childs (2003) ArticleTitlePrevalence of Helicobacter pylori in patients with gastroesophageal reflux disease: systematic review BMJ 326 737 10.1136/bmj.326.7392.737 Occurrence Handle10.1136/bmj.326.7392.737 Occurrence Handle12676842

    Article  PubMed  Google Scholar 

  22. L Laine J Sung (2002) ArticleTitleEffect of Helicobacter pylori eradication on development of erosive esophagitis and gastroesophageal reflux disease symptoms: a post hoc analysis of eight double blind prospective studies Am J Gastroenterol 97 2992–7 10.1111/j.1572-0241.2002.07116.x Occurrence Handle10.1111/j.1572-0241.2002.07116.x Occurrence Handle12492181

    Article  PubMed  Google Scholar 

  23. D McNamara C O’Morain (1999) ArticleTitleGastroesophageal reflux disease and Helicobacter pylori: an intricate relation Gut 45 IssueIDSuppl I 13–7 Occurrence Handle10.1136/gut.45.2008.i13

    Article  Google Scholar 

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Ang, T., Fock, K., Teo, E. et al. Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia: a randomized, double-blind study. J Gastroenterol 41, 647–653 (2006). https://doi.org/10.1007/s00535-006-1818-x

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  • DOI: https://doi.org/10.1007/s00535-006-1818-x

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