Functional dyspepsia has a good prognosis irrespective of H-pylori status - Long-term follow-up of symptoms after anti H-pylori treatment

Aim: A prospective study with anti H. pylori therapy was done in patients w ith functional dyspepsia. Methods: Inclusion criterion was the absence of any macroscopic abnormality in oesophagus, stomach, and duodenum, irrespective whether H. pylori was p resent or not. A questionnaire and a symptom score on a five-point Likert s cale were used. Antral biopsy specimens were taken for detection of ii. pyl ori. Treatment consisted of omeprazole 20 mg bid and amoxicilline 500 mg ti d during 14 days. Patients were followed during 12 months. At follow-up the questionnaire and the symptom score were used. The main endpoint of the st udy was clinical remission after 1 year of follow-up. Results: In 1 year 163 patients were included (85 men, 78 women, mean age 4 7 years, range 21-83 years). H. pylori was present in 91 patients. In the H . pylori positive group 38 patients showed a decrease in IEC antibody titre of more than 50% during follow-up of 3-12 months, 26 showed no change or i ncrease following initial decrease. Overall there was no difference in pres ence or absence of specific complaints at inclusion and final follow-up. Th e symptom score decreased significantly in all groups (P < 0.001). Conclusion: The symptoms of functional dyspepsia improved to a similar exte nt in both H. pylori positive dyspeptics and the control group. This sympto m improvement was irrespective of the change of IgG H. pylori antibodies af ter therapy. (C) 1999 Elsevier Science B.V. All rights reserved.