Relationship between Helicobacter pylori infection, histological gastritis, and functional dyspepsia

BACKGROUND/AIMS: It is still controversial as to whether or not Helicobacte r pylori (H. pylori) infection, histological gastritis, and functional dysp epsia (FD) are intercorrelated. We prospectively evaluated patients with fu nctional dyspepsia in an attempt to clarify this issue. METHODOLOGY: Eighty-eight consecutive patients with functional dyspepsia (a ge range: 18-84 years) who did not show disease(s) other than gastritis wer e investigated. In a questionnaire they were asked to report the presence o r absence of 8 upper gastrointestinal (GI) symptoms and to score them from 0 (absence) to 3 (severe), whereupon a sum score was calculated. Forty age- matched subjects with a sum score of <3 served as controls. Biopsy specimen s for histology, bacterial culture, and rapid urease test were taken. A C13 -urease breath test was also performed in 122 subjects. RESULTS: H. pylori infection was present in 43% of patients with functional dyspepsia and 35% of control subjects (not significant (n.s.)). None of th e symptoms were correlated with H. pylori infection. The median symptom sum score was 8.5 in H. pylori-positive and 9.5 in H. pylori-negative patients with functional dyspepsia (n.s.). Histological gastritis was strongly asso ciated with H. pylori infection but was not correlated with any of the symp toms. CONCLUSIONS: In a prospective population of patients with functional dyspep sia, H. pylori infection or gastritis are not associated with specific or s evere symptoms. Our data imply that H. pylori gastritis is not an important condition in the pathogenesis of dyspeptic complaints.