Editorials

Treating non-ulcer dyspepsia and H pylori

BMJ 2000; 321 doi: http://dx.doi.org/10.1136/bmj.321.7262.648 (Published 16 September 2000) Cite this as: BMJ 2000;321:648

It is economically and clinically sensible but it won't make most patients better

  1. Sander J O Veldhuyzen van Zanten, gastroenterologist ([email protected])
  1. Queen Elizabeth II Health Sciences Center, Victoria General Hospital Site, 1278 Tower Road, Halifax, NS, Canada B3H 2Y9

    Papers p 659

    H elicobacter pylori is the main cause of duodenal and gastric ulcers. The organism has also been linked to gastric cancer.1 Most researchers believe that there is a relation, although an imperfect one, between non-ulcer dyspepsia and infection with H pylori. The pathophysiological mechanisms by which the infection may cause dyspepsia are unclear, but may include changes in acid secretion, abnormal motility, or altered visceral perception.2 The prevalence of H pylori is higher in patients with non-ulcer dyspepsia than in healthy controls.3 A pivotal question is whether curing the infection leads to a sustained improvement in symptoms in patients with non-ulcer dyspepsia. The controversy surrounding this issue is addressed by the meta-analysis by Moayyedi et al in this issue of the journal (p 659).4

    Dyspepsia is defined as pain or discomfort in the central upper abdomen which originates in the upper gastrointestinal tract.5 To make the diagnosis of non-ulcer (functional) dyspepsia patients need to have had symptoms for at least 12 weeks and the presence of an organic disease, such as a peptic ulcer or oesophagitis, must be ruled out. …

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