The association between Helicobacter pylori infection and functional dyspepsia in patients with irritable bowel syndrome

OBJECTIVE: Irritable bowel syndrome (IBS) is associated with an exaggerated response to a variety of physiological and nonphysiological gastrointestin al stimuli. Many patients with IBS also have functional dyspepsia. Our aim was to examine the hypothesis that Helicobacter pylori (H. pylori) infectio n may predispose TSS patients to functional dyspepsia. METHODS: In 69 IBS patients, dyspeptic symptoms, H. pylori status, and soci odemographic and psychological variables (perceived stress, trait anxiety, and depression) were assessed. Sociodemographic and psychological variables were also evaluated in 52 control subjects. RESULTS: Mean scores for perceived stress (17.1 +/- 6.0 vs 14.9 +/- 6.0, p = 0.05), trait anxiety (45.6 +/- 9.1 vs 41.1 +/- 7.8, p = 0.004) and depres sion (9.9 +/- 8.4 vs 5.0 +/- 5.5, p = 0.0002) were higher in IBS patients t han in controls. In all, 33 of the 69 patients (47.8%) had H. pylori infect ion, and this was associated with relevant symptoms of epigastric pain (odd s ratio [OR] = 6.77, 95% confidence interval [CI] 1.89-24.3) and postprandi al upper abdominal fullness (OR = 4.23, 95% CI 1.38-13.2). N. pylori infect ion and female gender were independent predictors of the presence of releva nt dyspepsia (OR = 8.31, 95% CI 2.35-29.5 and 6.06, 95% CI 1.71-21.5, respe ctively). Symptom intensity was associated with the level of perceived stre ss (total relevant symptom number greater than or equal to 3 vs <3, OR = 1. 16 per point on a 40-point perceived stress scale, 95% CI 1.01-1.34). CONCLUSIONS: In IBS patients, the presence of dyspepsia is associated with H. pylori infection, female gender, and perceived stress. (C) 2000 by Am. C oll. of Gastroenterology.