Eradication of Helicobacter pylori affects symptoms in non-ulcer dyspepsia

Background: The relationship between Helicobacter pylori infection and non-ulcer dyspepsia is controversial. Methods: In a prospective, long term, double-blind study we randomized 100 patients with nonulcer dyspepsia and H. pylori infection to receive either of two treatment regimens: 1) bismuth-based triple therapy (n = 50) or 2) bismuth + placebo (n = 50). Results: Triple therapy: subjects who became H. pylori negative (n = 42) showed a significant symptomatic response when interviewed at 8 weeks, 6 months, and 1 year (P < 0.01). This improvement was evident in the 'ulcer like' dyspepsia group at all times (P < 0.01) but in the 'reflux-like' and 'motility-like' groups at 6 months only (P < 0.01). Those who remained H. pylori-positive showed no decrease in symptoms at 8 weeks, 6 months, and 1 year. Bismuth-placebo therapy: subjects who became H. pylori-negative (n = 7) showed an improvement in symptoms at 8 weeks, 6 months, and 1 year. Those who continued to harbour the infection after treatment (n = 42) showed an insignificant improvement in the motility and non-specific groups only. Conclusion: This study shows that eradication of H. pylori results in a significant long-term reduction in symptoms of non-ulcer dyspepsia.