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 .
Dyspepsia, Helicobacter pylori, and peptic ulcer in a randomly selected population in India.
There seems to be a worldwide geographic variation in the prevalence of peptic ulcer disease , although there are few reliable population based studies . This study aim ed to determine the prevalence of peptic ulcer disease in a community in southern India and to evaluate the relationship between dyspeptic symptoms , Helicobacter pylori infection , gastritis , and peptic ulcer disease . A sample population was selected r and omly from a rural monastic settlement in southern India . Subjects were interviewed using a st and ardised symptom and demography question naire then underwent upper endoscopy and antral biopsy for histology and CLO rapid urease test .  Altogether 197 subjects from a population of 1499 ( 13.1 % ) were studied . All were male monks and ethnically Tibetan . The median age was 28 years ( range : 21 - 81 ) . None smoked or took NSAIDs . The six month period prevalence of dyspeptic symptoms was 68.5 % . Current symptoms were present in 58.9 % of subjects . Dyspepsia was more common in subjects aged 40 years or younger ( p < 0.0001 ) . H pylori was detected in 77.2 % subjects . There was no association between dyspepsia and the presence of H pylori or histological gastritis , although there was a strong correlation between symptoms and ulcer ( p < 0.003 ) . The point prevalence of active peptic ulcer was 6.6 % ( 13/197 ) . All ulcers detected were either prepyloric or pyloroduodenal in location . A further 6.6 % of subjects had definite evidence of scarring or deformity indicative of ulceration in the past . Subjects with past or present ulcers comprised 17.8 % of dyspeptic subjects . H pylori was present in all subjects with active ulcers and in 12/13 of those with scarring . Dyspepsia , H pylori infection , gastritis , and peptic ulcer are all more common in this population than in those from developed countries . Ulcer disease , however , accounts for only a small proportion of subjects with symptoms and neither H pylori infection nor gastritis are significantly associated with the presence of dyspepsia
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 .