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 .
Relation between Helicobacter pylori infection and gastrointestinal symptoms and syndromes
Background —Helicobacter pylori is a human pathogen that colonises the gastric mucosa and causes permanent gastric inflammation . Aims —To assess the symptoms of H pylori infection in an adult unselected population . Subjects — A r and om sample of 3589 adult Danes who were examined in 1982 and 1987 ( n=2987 ) . Methods —Abdominal symptoms within the preceding year were recorded at both attendances . Circulating IgG antibodies against H pylori in serum sample s drawn in 1982 were measured by using in-house indirect enzyme linked immunosorbent assays ( ELISA ) . Results —People with increased levels of IgG antibodies to H pylori were more likely than uninfected individuals to report heartburn ( odds ratio ( OR ) = 1.26 , 95 % confidence interval ( CI ) 1.03–1.54 ) and abdominal pain characterised by daily length ( OR = 1.33 , 95 % CI 0.92–1.91 ) , nocturnal occurrence ( OR = 1.62 , 95 % CI 1.19–2.19 ) , spring aggravation ( OR = 1.68 , 95 % CI 0.70–4.05 ) , and no relation to meals ( OR = 0.62 , 95 % CI 0.43–0.91 ) or stress ( OR = 0.69 , 95 % CI 0.50–0.95 ) . The inclusion of people with increased levels of IgG antibodies to H pylori , but without upper dyspepsia , at study entry significantly increased the likelihood of reporting upper dyspepsia at follow up ( OR = 1.71 , 95 % CI 1.24–2.36 ) . People with epigastric pain and increased levels of IgM antibodies to H pylori only indicative of acute H pylori infection were more likely to report nocturnal pain , heartburn , nausea , and vomiting . Conclusions —H pylori infection may precede the development of dyspepsia and is associated with a variety of gastrointestinal symptoms in people with no history of peptic ulcer disease
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 .