There are some benefits for eradicating Helicobacter pylori in patients with non-ulcer dyspepsia

Background: The relationship between Helicobacter pylori infection and non- ulcer dyspepsia is not established. Aim: To determine whether eradication of H. pylori might be of benefit in n on-ulcer dyspepsia patients. Methods: We randomly assigned 129 H. pylori infected patients with severe e pigastric pain, without gastro-oesophageal reflux symptoms, to receive twic e daily treatment with 300 mg of ranitidine, 1000 mg of amoxicillin, and 50 0 mg of clarithromycin for 7 days and 124 such patients to receive identica l-appearing placebos. Results: Treatment was successful (decrease of symptoms at 12 months) in 62 % of patients in the active-treatment group and in 60% of the placebo group (N.S.). At 12 months, the rate of eradication of H. pylori was 69% in the active-treatment group and 18% in the placebo group (P < 0.001). Complete r elief of symptoms occurred significantly more frequently in patients on the active treatment (43%) than in placebo-treated patients (31%, P=0.048). Wi thin the active-treatment group, therapeutic success was significantly more frequent in the non-infected patients (84% vs. 64%, P=0.04). Conclusions: Although eradicating H. pylori is not likely to relieve sympto ms in the majority of patients with non-ulcer dyspepsia, a small proportion of H. pylori-infected patients may benefit from eradication treatment.