The effect of Helicobacter pylori eradication in patients with functional dyspepsia: assessment of different diagnostic tests.

BACKGROUND/AIMS: Helicobacter pylori infection, is seen in more than 80% of adult population in Turkey. The aims of this study were 1) to evaluate the importance of the diagnostic tests 2) to investigate the relationship between Hp infection and functional dyspepsia.

METHODS: A total 75 patients with functional-dyspepsia were involved into the study. Hp infection was diagnosed by histopathological examination. CLO, cytology, culture, stool antigen and breath test. Symptom score using ROME II criteria was also evaluated to all patients. All patients were taken ranitidine-bismuth-citrate (400mg bid/day), clarithromycin (500 mg bid/day) and amoxicillin (1000 mg bid/day) for 14 days. All tests and symptom score analyses were re-applied at month 1 and 6.

RESULTS: The eradication rate was 95.9%. The baseline specifity of breath test, CLO, cytology, culture and stool antigen were 87.3%, 95.4%, 95.4% 94.5% and 86.4%, respectively. The sensitivity of such tests at first month after stopping the treatment were 86.1%, 100%, 100%, 100%, 84.7%, respectively, and were 91.6%, 100%, 100%, 100%, 87.5%, respectively at six months after treatment. Symptom scores were 29.6+/-5.4, 15.8+/-4.7 and 17.9+/-5.3 at baseline, first month and six months after treatment, respectively (p<0.001).

CONCLUSIONS: The success of eradication may be related to use of bismuth which prevents antibiotic resistance development. Stool antigen and breath tests are less effective than invasive diagnostic-tests. The finding of improved symptomscores after eradication suggests that Hp may play a role in functional dyspepsia.