Previous studies on the treatment of Helicobacter pylori infection in functional dyspepsia have shown little, if any, effect on dyspeptic symptoms.
However, whether such treatment might be of benefit in patients resistant to acid inhibitors has not been formally tested.
In this study, researchers from Switzerland and Germany investigated the effect of H. pylori treatment in patients with functional dyspepsia, resistant to conventional treatment.
The team assessed 181 H. pylori-positive patients with chronic functional dyspepsia, who had not responded to a 1 week antacid run-in and 2 week double-blind antisecretory, or placebo treatment were included.
The researchers randomized the patients to 2 weeks of treatment with omeprazole 40 mg twice daily, combined with amoxicillin 1 g twice daily, or omeprazole 20 mg once daily alone.
|H. pylori infection was healed in 10% of patients after omeprazole, and in 52% after omeprazole plus amoxicillin.|
The primary outcome was defined as no need for further therapy or investigations for dyspeptic symptoms 4 to 6 months after treatment.
The research team found that H. pylori infection was healed in 10% of patients after omeprazole, and in 52% after omeprazole plus amoxicillin. Response rates were 66% and 62%, respectively.
Overall, H. pylori treatment and cure of infection had no effect on complete resolution of all dyspeptic symptoms, individual symptoms, or various aspects of quality of life.
Prof. Koelz's team concluded, "In functional dyspepsia, H. pylori treatment and cure of H. pylori are no more effective for symptoms over 6 months than short term acid inhibition".
"These results do not support treatment of H. pylori in functional dyspepsia".