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Gut 1997;41:169-176; doi:10.1136/gut.41.2.169
Copyright © 1997 BMJ Publishing Group Ltd & British Society of Gastroenterology.
GUT 1997;41:169-176 ( August )

Relation between Helicobacter pylori infection and gastrointestinal symptoms and syndromes

S Rosenstock,ab L Kay,b C Rosenstock,b L P Andersen,c O Bonnevie,d T Jørgensenab

a Department of Surgery K, Bispebjerg University Hospital, Copenhagen, Denmark, b Glostrup University Hospital, Glostrup, Denmark, c National University Hospital, Copenhagen, Denmark, d Bispebjerg University Hospital, University of Copenhagen, Denmark

Correspondence to: Dr S Rosenstock, Department of Urology U, Frederiksberg Hospital, Nordre Fasanvej 57, 2000 F, Copenhagen, Denmark.

Accepted for publication 20 February 1997

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 random 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 samples 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.
(GUT 1997;41:169-176)

Keywords: epidemiology;  Helicobacter pylori; non-ulcer dyspepsia;  symptomatology;  upper dyspepsia

© 1997 by Gut
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