Eradication of Helicobacter pylori prevents ulcer development in patients with ulcer-like functional dyspepsia

Background: Although the eradication of Helicobacter pylori infection benef its patients with gastric or duodenal ulcers, the value of eradicating the infection in the patients with functional dyspepsia (FD) remains controvers ial. Aims: To determine whether eradicating H. pylori can prevent the subsequent development of ulcers or relieve the symptoms of functional dyspepsia pati ents. Methods: In a double-blind, placebo-controlled trial, 161 patients infected with H. pylori who had functional dyspepsia were randomly assigned to 7 da ys of treatment with a lansoprazole-based triple therapy or placebo and the n followed for 1 year. The main outcome measures were the development of pe ptic ulcers and the resolution of symptoms. Results: H. pylori was eradicated in 63 out of 81 patients (78%) in the tre atment group and none of the 80 patients (0%) in the placebo group. During the follow-up period, two patients in the treatment group and six patients in the placebo group developed peptic ulcers at repeat endoscopy (2.5% vs. 7.5%; 95% CI: -12 to 2). The reduction in ulcer rates was statistically sig nificant in the 'ulcer-like' sub-group (0% vs. 16.7%; 95% CI: -32 to -2), b ut not in the 'dysmotility-like' and 'unclassifiable' sub-groups. Regarding symptom response, the resolution rates of symptoms were similar between th e treatment and placebo groups (58.0% vs. 55.0%, 95% CI: -12 to 18). Additi onally, no significant differences existed in the symptom responses between the treatment and control arms in each of the dyspepsia sub-groups. Conclusions: Eradicating H. pylori can prevent the subsequent development o f peptic ulcers in the patients with 'ulcer-like' functional dyspepsia. How ever, this approach does not significantly reduce the symptoms of functiona l dyspepsia patients.