[Peptic ulcer, functional dyspepsia, Helicobacter pylori: a 1998 stock-taking on the topic of their correlation and therapeutic strategies].

While the correlation between Helicobacter pylori and peptic ulcer is accepted worldwide, the role of Hp in functional dyspepsia is still a debatable issue. Therefore, Hp eradication in all dyspeptic patients has both supporters and opponents. In contrast, anti-Hp regimens are increasingly well defined, most convincing treatments being triple therapies consisting of one proton pump inhibitor (PPI) or ranitidine bismuth citrate (RBC) plus two antimicrobials. Duration of anti-Hp regimens varies from 2 weeks (more usually adopted in USA) and 1 week (more usually adopted in Europe). Due to the short and simple anti-Hp triple therapies, side effects prove to be few and negligible and patient compliance is significantly better. By contrast, Hp resistance to extensively used antimicrobials, such as metronidazole and clarithromycin, is more than an emerging problem causing significantly lower eradication rates. Very recent data indicate that RBC-based triple therapy is much less affected by the helicobacterial resistance, and is also effective in non-responders to a PPI-based triple therapy.