Reports of strong associations in small observational studies without appropriate adjustment for potential confounding factors were not generally confirmed by larger and better- design ed studies .
The available evidence indicates that there is no strong association between H pylori and dyspepsia , but there is insufficient evidence to confirm or refute the existence of a modest association
BACKGROUND Previous studies have yielded conflicting results and substantial uncertainty about any independent association of Helicobacter pylori infection with dyspepsia , and about any benefits of antibiotic treatments for nonulcer or uninvestigated dyspepsia .
OBJECTIVES To perform a systematic review of the literature to determine whether chronic infection with H pylori is relevant to nonulcer or uninvestigated dyspepsia .
Eradication ofHelicobacter pylori and long-term outcome of functional dyspepsia
The aim of this study was to assess the effect of colloidal bismuth subcitrate ( CBS ) and metronidazole on Helicobacter pylori eradication and on the course of symptoms due to functional dyspepsia . Forty-one patients with functional dyspepsia were entered into the study and r and omized to treatment with CBS ( 120 mg four times a day ) for four weeks combined with metronidazole ( 250 mg four times a day ) for one week ( group A , N=21 ) or matching placebo ( group B , N=20 ) . The severity of gastritis and of bacterial colonization and the symptom score was assessed by endoscopy and clinical evaluation at baseline and after four , eight , and 24 weeks from the start of the treatment . With intent-to-treat analysis eradication was achieved in 16/25 ( 64 % ) patients in group A and in 6/24 ( 25 % ) in group B. At eight and 24 weeks the gastritis score was significantly lower only in those patients with eradication . No change was seen in patients in whom the bacteria was not eradicated . The symptom score at eight weeks was considerably lower both in patients with eradication and in those with infection . However , at 24 weeks a gradual decrease in the symptom score in patients with eradication and a worsening of symptoms in controls was observed . No differences were observed between patients with ulcerlike and those with dysmotility-like dyspepsia .  The study confirms the need for a long observation period after antibacterial treatment in patients with functional dyspepsia and suggests thatHelicobacter pylori-eradicating treatment improves the course of this functional syndrome
Reports of strong associations in small observational studies without appropriate adjustment for potential confounding factors were not generally confirmed by larger and better- design ed studies .
The available evidence indicates that there is no strong association between H pylori and dyspepsia , but there is insufficient evidence to confirm or refute the existence of a modest association
BACKGROUND Previous studies have yielded conflicting results and substantial uncertainty about any independent association of Helicobacter pylori infection with dyspepsia , and about any benefits of antibiotic treatments for nonulcer or uninvestigated dyspepsia .
OBJECTIVES To perform a systematic review of the literature to determine whether chronic infection with H pylori is relevant to nonulcer or uninvestigated dyspepsia .