At the present, Helicobacter-associated gastritis is not considered to
be an important cause of dyspeptic symptoms. Therefore, patients with
dyspeptic symptoms and proven Helicobacter-gastritis are diagnosed as
having functional dyspepsia, provided that Helicobacter-associated le
sions like ulcers or malignancies are absent. It is controversial whet
her or not to treat a patient with functional dyspepsia with Helicobac
ter gastritis. Conclusive controlled clinical trials are lacking. If i
t is assumed in a given patient, that Helicobacter could be responsibl
e for the complaints jan assumption which can never be proven and only
suspected when the patient remains asymptomatic during longterm follo
w-up after cure of the infection) and if the patient has not responded
to a standard treatment (antisecretory or prokinetic agents), we reco
mmend Helicobacter therapy. Presently, in spring 1995, the following t
reatment is, in our view, the best choice during seven (to ten) days:
The patient takes 20 mg omeprazol in the morning, 250 mg clarithromyci
n in the morning acid in the evening and 500 mg metronidazole in the m
orning and in the evening.