Effect of Eradication of Helicobacter Pylori on the Dyspeptic Symptoms

Effect of Eradication of Helicobacter Pylori on the Dyspeptic Symptoms.

Helicobacter pylori eradication and its impact on symptoms in patients with non-ulcer dyspepsia remain controversial . Many studies have examined the effect of H. pylori eradication on dyspeptic symptoms, but the results have been conflicting and inconclusive, with as many studies yielding positive as negative results. Some studies have shown a significant (although weak) symptomatic improvement after H. pylori eradication, and while other yielding negative results. A recent Cochrane review has comprehensively demonstrated that H.pylori eradication therapy has a small but statistically significant effect in H.pylori positive non-ulcer dyspepsia. An economic model suggests this modest benefit may still be cost effective . However it is difficult to reconcile these results in areas with very high prevalence of H. pylori infection such as Pakistan since no such studies have been conducted in developing countries.

The investigators hypothesize that eradication of Helicobacter pylori (H. pylori) leads to a sustained improvement in symptoms of patients diagnosed with H. pylori associated functional (non-ulcer) dyspepsia.

Inclusion Criteria:

• Ambulatory adult males and non-pregnant females.
• Dyspeptic symptoms for at least 3 months.
• Normal endoscopic findings.
• H. Pylori positive on testing.

Exclusion Criteria:

• Patients with erosive and non erosive esophagitis.
• Barrette's esophagus.
• Duodenal Ulcer, Gastric Ulcer or gastric erosions.
• Patients with known sensitivity to antibiotics.
• Patients with severe concomitant systemic disease.
• Patients with upper GI surgery except cholecystectomy.
• Females with pregnancy or breast-feeding.
• Malignancy
• Alarm symptoms such as bleeding per rectum, hematemesis, and severe weight loss.