Eradicating H pylori
BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7453.1388 (Published 10 June 2004) Cite this as: BMJ 2004;328:1388
- Brendan Delaney, professor of primary care (b.c.delaney@bham.ac.uk),
- Paul Moayyedi, Richard Hunt-AstraZeneca professor of gastroenterology
- Department of Primary Care and General Practice, University of Birmingham, Birmingham B15 2TT
- Department of Medicine, McMaster University, Hamilton, ON, Canada L8N 3Z5
Does not increase symptoms of gastro-oesophageal reflux disease
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 …
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