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Debate
Antagonist: Should we eradicateHelicobacter pylori in non-ulcer dyspepsia?
  1. D Pantoflickova,
  2. A L Blum
  1. Division of Gastroenterology, Department of Medicine, University Hospital, CHUV, CH-1011 Lausanne, Switzerland
  1. AL Blum, Rue de Collège, CH1323 Romainmotier, Switzerland. andre.blum{at}chuv.hospvd.ch

https://doi.org/10.1136/gut.48.6.758

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    Treatment of Helicobacter pyloriinfection in non-ulcer dyspepsia (NUD) should only be recommended if the following—still unproved—associations can be made. Firstly, epidemiological studies show a link between H pylori and dyspeptic symptoms and, secondly, treatment studies demonstrate such a link (table 1). We will examine results from these two types of studies.

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    Table 1

    Summary points

    Epidemiological studies

    Forty two epidemiological studies compared the prevalence ofH pylori infection in dyspeptic patients and asymptomatic controls (see website fig 1). Meaningful studies should use the following design: an appropriate definition of dyspepsia; adequate sample size; dyspeptic subjects and controls sampled from the general population; and results adjusted for potential confounders such as age, sex, smoking, ethnicity, and socioeconomic status.

    Of 20 endoscopic studies, only two were population based and used adequate controls matched at least for age and sex (see website fig 1A).1 ,2 The prevalence of H pylori infection in NUD subjects and in asymptomatic controls was similar in one study.2 The results of the other …

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