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 .
Are routine duodenal and antral biopsies useful in the management of "functional" dyspepsia? A diagnostic and therapeutic study.
Fifty-three patients with previously uninvestigated chronic dyspepsia symptoms in the absence of gastrointestinal or extra-gastrointestinal disease ( functional dyspepsia ) underwent antral and duodenal mucosal biopsies to detect the role of such samplings in the presence of normal endoscopic findings . Patients were enrolled in a r and omized , placebo-controlled , double-blind trial , receiving either eradicating treatment ( colloidal bismuth subcitrate plus metronidazole ) or placebo if they had Helicobacter pylori-associated gastritis ( 20 patients ) , or cisapride or placebo if they had normal antral mucosa ( 28 cases ) . Unsuspected celiac sprue was found in one patient . Eradicating treatment ameliorated histological gastritis ( p = 0.01 ) . However , owing to great placebo efficacy , symptom remission rates following a 1-month wash-out period in both treatment groups were no higher than that in controls . Independent of the initial r and omization , an extremely low symptom recurrence rate was observed during a drug-free follow-up study equivalent to the mean duration of symptoms before enrollment . We conclude that in functional dyspepsia , bulbar and antral biopsies are not useful in clinical management , equivalent symptom relief can be achieved in patients r and omly assigned to both drugs and placebos , and such improvement can be long lasting in the absence of any maintenance treatment . We believe the prevalence of unsuspected villous atrophy and the therapeutic role of investigation-based reassurance deserve further assessment
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 .