H pylori and functional dyspepsia Reply
Authors: N J TALLEY
Journal: Gut (2001)

Editor,—I read with interest the results reported by Blum et al ((2000) Gut 47:473–80; [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4]) and the editorial which accompanied this article by McColl ((2000) Gut 47:461–4; [OpenUrl][5][Abstract/FREE Full Text][6]). Professor McColl argues that the greater response to acid suppression observed in the Helicobacter pylori positive compared with the negative subjects in the Blum trial resulted from a lack of blinding of the investigators and the presence of an incentive for categorising H pylori positive subjects as non-responders. In support of this argument, he cites pooled data from two large randomised controlled trials (BOND and OPERA)1comparing omeprazole 20 mg, 10 mg, and placebo where overall no significant relationship between H pylori status and symptom relief was observed. However, there may be other explanations for the results observed by Blum et al . We have previously reported in pooled data from the BOND and OPERA trials that in the H pylori positive group, 43% on omeprazole 20 mg had complete relief of dyspeptic symptoms (by intention to treat) compared with 35% in H pylori negative patients (versus 34% and 24% on placebo, respectively).1 Hence there was a small therapeutic gain observed in H pylori positive patients receiving omeprazole 20 mg versus those who were H pylori negative although the differences were not statistically … [1]: {openurl}?query=rft.jtitle%253DAlimentary%2Bpharmacology%2B%2526%2Btherapeutics%26rft.stitle%253DAliment%2BPharmacol%2BTher%26rft.aulast%253DTalley%26rft.auinit1%253DN.%2BJ.%26rft.volume%253D12%26rft.issue%253D11%26rft.spage%253D1055%26rft.epage%253D1065%26rft.atitle%253DEfficacy%2Bof%2Bomeprazole%2Bin%2Bfunctional%2Bdyspepsia%253A%2Bdouble-blind%252C%2Brandomized%252C%2Bplacebo-controlled%2Btrials%2B%2528the%2BBond%2Band%2BOpera%2Bstudies%2529.%26rft_id%253Dinfo%253Adoi%252F10.1046%252Fj.1365-2036.1998.00410.x%26rft_id%253Dinfo%253Apmid%252F9845395%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1046/j.1365-2036.1998.00410.x&link_type=DOI [3]: /lookup/external-ref?access_num=9845395&link_type=MED&atom=%2Fgutjnl%2F49%2F5%2F738.2.atom [4]: /lookup/external-ref?access_num=000077279200002&link_type=ISI [5]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.aulast%253DMoayyedi%26rft.auinit1%253DP.%26rft.volume%253D321%26rft.issue%253D7262%26rft.spage%253D659%26rft.epage%253D664%26rft.atitle%253DSystematic%2Breview%2Band%2Beconomic%2Bevaluation%2Bof%2BHelicobacter%2Bpylori%2Beradication%2Btreatment%2Bfor%2Bnon-ulcer%2Bdyspepsia%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fbmj.321.7262.659%26rft_id%253Dinfo%253Apmid%252F10987767%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [6]: /lookup/ijlink?linkType=ABST&journalCode=bmj&resid=321/7262/659&atom=%2Fgutjnl%2F49%2F5%2F738.2.atom