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 .
Accuracy of invasive and noninvasive tests to diagnose Helicobacter pylori infection.
BACKGROUND & AIMS Multiple tests are available for determining Helicobacter pylori infection . Our aim was to compare the sensitivity , specificity , and negative and positive predictive value of the most widely available tests for diagnosis of H. pylori . METHODS A total of 268 patients ( mean age , 53.7 + /- 15.8 years ; 142 male and 126 female ; 125 white and 143 nonwhite ) was tested for H. pylori infection by [13C]urea breath test ( UBT ) , measurement of serum immunoglobulin ( Ig ) G and IgA antibody levels , and antral biopsy specimens for CLO test , histology , and Warthin-Starry stain . No patient received specific treatment for H. pylori before testing . The infection status for each patient was established by a concordance of test results . RESULTS Warthin-Starry staining had the best sensitivity and specificity , although CLO test , UBT , and IgG levels were not statistically different in determining the correct diagnosis . The absence of chronic antral inflammation was the best method to exclude infection . Stratification of results by clinical characteristics showed that UBT and chronic inflammation were the best predictors of H. pylori status in patients older than 60 years of age . IgA was a better predictor in white patients . CONCLUSIONS The noninvasive UBT and IgG serology test are as accurate in predicting H. pylori status in untreated patients as the invasive tests of CLO and Warthin-Starry
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 .