This meta-analysis suggests that alternate therapy to H. pylori eradication is advisable in patients with diagnosed nonulcer dyspepsia who do no have an underlying organic disorder, such as duodenal or gastric ulcer. Other therapy to be explored in these patients include prokinetic agents, acid suppression, psychotropic therapy, or antinociceptive therapy. The results of this trial do not support treatment of H. pylori infection in diagnosed nonulcer dyspepsia. While H. pylori is easily detectable by urea breath test or serology, overtreatment of H. pylori with double or triple antibiotic regimens can lead to antibiotic resistance and increase in health care costs. What this meta-analysis does not answer, is whether H. pylori should be eradicated in uninvestigated dyspepsia.
Further study is required to elucidate the appropriate management of uninvestigated dyspepsia.
Fallone CA, Thomson ABR, Canadian Helicobacter Study Group. Management of nonulcer dyspepsia. The statistical basis of meta-analysis. NIH Consensus Development Panel on Helicobacter pylori in peptic ulcer disease. Helicobacter pylori in peptic ulcer disease.