BMJ  2004;328:1388-1389 (12 June), doi:10.1136/bmj.328.7453.1388

Editorial

Eradicating H pylori

Does not increase symptoms of gastro-oesophageal reflux disease

The first 150 words of the full text of this article appear below.

Does eradication of Helicobacter pylori lead to an increase in symptoms of gastro-oesophageal reflux disease? We need to know this because the benefits of eradicating H pylori relative to acid suppression alone are small in non-ulcer dyspepsia and uninvestigated dyspepsia.^{1 2} The absolute benefits are 6-7%, and even a small increase in gastro-oesophageal reflux disease would be likely to make eradicating H pylori in these patients of dubious benefit. New guidelines for the management of dyspepsia in Scotland and forthcoming guidelines in England and Wales recommend eradicating H pylori in both non-ulcer dyspepsia and uninvestigated dyspepsia.^{3 4} In addition, advocates of population screening for and treating H pylori to prevent distal gastric cancer need to ensure that the risk-benefit ratio is favourable.

The trial reported by Harvey et al in this issue does not find an increase in reflux symptoms in those randomised to eradication therapy (p 1417).⁵ A previous . . . [Full text of this article]

Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TT (b.c.delaney@bham.ac.uk)

Department of Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5

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• Barton, P. M., Moayyedi, P., Talley, N. J., Vakil, N. B., Delaney, B. C. (2008). A Second-Order Simulation Model of the Cost-Effectiveness of Managing Dyspepsia in the United States. Med Decis Making 28: 44-55 [Abstract]  
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