Eradication of Helicobacter pylori infection in the management of patientswith dyspepsia and non-ulcer dyspepsia

Although H. pylori infection has been recognized as a major etiological age nt for the development of chronic active gastritis, duodenal ulcer and beni gn non-NSAID related gastric ulcer, its role in the development of symptoms in patients with dyspepsia remains uncertain. Results from population-base d epidemiological studies have been conflicting regarding a causal link bet ween H. pylori infection and dyspepsia. Abnormalities in gastric acid secre tion may exist in some dyspeptic patients. Whether disordered gastric motil ity seen in dyspeptic patients is related to the infection is not clear bas ed on the results in the literature. Numerous clinical trials have been und ertaken to eradicate H. pylori infection and improve the symptoms in dyspep tic patients; however, the results have been discrepant between studies. Ma ny published studies suffer from methodological problems that have made int erpretation difficult. Large, well-conducted, randomized, placebo-controlle d, clinical trials with long-term follow-up are needed to justify the benef icial effect of H. pylori eradication treatment in dyspeptic patients seen in some small studies. H. pylori eradication therapy is cost-effective in H . pylori-infected dyspeptic patients although this benefit may take a long time to accrue, especially in younger patients.