Role of anti-Helicobacter pylori treatment in H-Pylori-positive and cytoprotective drugs in H-Pylori-negative, non-ulcer dyspepsia: Results of a randomized, double-blind, controlled trial in Asian Indians

Background: The efficacy of anti-Helicobacter pylori treatment and cytoprot ective drugs in H. pylori-positive and -negative non-ulcer dyspepsia (NUD), respectively, is debatable. Methods: In a randomized study, the efficacy of anti-H. pylori treatment ve rsus sucralphate was tested in patients with NUD. One hundred and twelve pa tients with NUD, 62 positive and 50 negative for H. pylori were studied. Of 62 patients positive for H. pylori, 32 were treated with triple therapy (c olloidal bismuth subcitrate, tetracycline and metronidazole) for 2 weeks an d the remaining 30 were treated with sucralphate (1 g, q.i.d.) for 4 weeks. Of 50 patients negative for H. pylori, 25 each were treated with either su cralphate (1 g, q.i.d.) or ranitidine (150 mg, b.d.) for 4 weeks. Results: In patients with NUD and H. pylori infection, triple therapy eradi cated H. pylori in 88% and was superior to sucralphate in producing symptom relief (81 vs 33%, P = 0.0003) and histological improvement in gastritis ( 73 vs 30%, P = 0.003). In the H. pylori-negative: group, sucralphate was su perior to ranitidine with regard to symptom relief (68 vs 36%, P = 0.04) an d improvement in gastritis (44 vs 12%, P = 0.09). The symptomatic improveme nt persisted until 12 weeks after the start of treatment in triple therapy group only. Conclusions: In patients with NUD associated with H. pylori, triple therapy was better than sucralphate in terms of symptomatic and histological impro vement. However, sucralphate was superior to ranitidine in providing sympto m relief in patients with H. pylori-negative NUD. (C) 1999 Blackwell Scienc e Asia Pty Ltd.