EFFECTS OF HELICOBACTER-PYLORI ERADICATION ON GASTRIC FUNCTION INDEXES IN FUNCTIONAL DYSPEPSIA - A PROSPECTIVE CONTROLLED-STUDY

Background: To date, it is unclear whether Helicobacter pylori infecti on is associated with disturbances of gastric emptying or acid secreti on in patients with functional dyspepsia (FD). Our aim was to investig ate whether, in the long run, cure of H. pylori infection significantl y influences gastric emptying of solids, acid secretion, and gastrin a nd pepsinogen I (PGI) release in patients with FD. Methods: Thirty-eig ht consecutive H. pylori-positive patients with FD, whose complaints w ere scored for severity and frequency on the basis of a validated symp tom questionnaire, were initially enrolled in the study. They were ran domized to receive an eradicating regimen consisting of omeprazole plu s clarithromycin and tinidazole for I week or full-dose ranitidine for 3 weeks. In 33 patients (18 H. pylori-cured and 15 with persistent in fection) basal and pentagastrin-stimulated acid secretion, fasting and meal-induced gastrin concentrations, fasting serum PGI levels, and ga stric emptying of solids were determined before and 6 months after the rapy. Results: In the 18 H. pylori-cured patients meal-induced gastrin and fasting PGI levels were significantly reduced after 6 months as c ompared with pretreatment values (peak serum gastrin, 76.0 +/- 23.4 ve rsus 111.9 +/- 37.4 pg/ml; PGI, 57.1 +/- 23.4 versus 72.9 +/- 29.1 ng/ ml), whereas they remained virtually unchanged in the 15 patients with persistent infection. In contrast, both basal and stimulated acid sec retion and gastric emptying time of solids remained unmodified over ti me in both groups of patients. Conclusions: We confirm that also in pa tients with functional dyspepsia H. pylori eradication in the long run significantly reduces gastrin and PGI release as a result of improvem ent in the underlying antral gastritis, but this is not accompanied by modifications of gastric emptying of solids or acid secretion.