ERADICATION OF HELICOBACTER-PYLORI AND LONG-TERM OUTCOME OF FUNCTIONAL DYSPEPSIA - A CLINICAL ENDOSCOPIC STUDY

The aim of this study was to assess the effect of colloidal bismuth su bcitrate (CBS) and metronidazole on Helicobacter pylori eradication an d on the course of symptoms due to functional dyspepsia. Forty-one pat ients with functional dyspepsia were entered into the study and random ized to treatment with CBS (120 mg four times a day) for four weeks co mbined with metronidazole (250 mg four times a day) for one week (grou p A, N = 21) or matching placebo (group B, N = 20). The severity of ga stritis and of bacterial colonization and the symptom score was assess ed by endoscopy and clinical evaluation at baseline and after four, ei ght, and 24 weeks from the start of the treatment, With intent-to-trea t analysis eradication was achieved in 16/25 (64%) patients in group A and in 6/24 (25%) in group B. At eight and 24 weeks the gastritis sco re was significantly lower only in those patients with eradication, No change was seen in patients in whom the bacteria was not eradicated. The symptom score at eight weeks was considerably lower both in patien ts with eradication and in those with infection. However, at 24 weeks a gradual decrease in the symptom score in patients with eradication a nd a worsening of symptoms in controls was observed, No differences we re observed between patients with ulcerlike and those with dysmotility -like dyspepsia. The study confirms the need for a long observation pe riod after antibacterial treatment in patients with functional dyspeps ia and suggests that Helicobacter pylori-eradicating treatment improve s the course of this functional syndrome.