JBM  Vol.6 No.10 , October 2018
Prevalence of Helicobacter pylori and the Interest of Its Eradication during the Functional Dyspepsia
Abstract: Functional dyspepsia constitutes by its impact in quality of life and socio-economic impact areal public health problem (40% of the adult population in the Western world). The prevalence of infection with Helicobacter pylori (HP) in patients with functional dyspepsia is about 30% - 70%. The aim of our study is to observe the improvement of functional dyspepsia (FD) after Helicobacter pylori (HP) eradication. Methods: This is a prospective study over a period of 68 months (May 2009 - January 2015). We included all patients aged over 15 years, with functional dyspepsia defined by the Rome III criteria. The diagnosis of HP was made by histology and/or PCR. Patients infected with HP were treated in single-blind: standard triple therapy for 7 days or sequential treatment for 10 days. HP eradication control was made after: 3 months, 6 months and one year of treatment. Results: During the study period, 1190 patients were included of which 250 patients (21%) were in functional dyspepsia according to the Rome III criteria. The average age in patients with functional dyspepsia was 49 years [16 - 80], sex ratio M/F was 0.58 (N = 92/158). 60% of patients were older than 45 years (N = 150). Chronic smoking was found in 20% of patients (N = 50). One hundred and seventy five patients (70%) had HP infection (N = 175). One hundred and sixty five patients received the treatment of Helicobacter pylori (94.28%), 10 patients were lost to follow (5.71%). The eradication of HP was obtained in 98.41% with sequential treatment versus 88.73% with standard triple therapy (p = 0.026). All patients were reviewed at 3 months and 6 months after treatment, 86% were reviewed at 12 months (N = 143). Dyspeptic symptoms was disappeared in 43% of our patients (N = 71) partial disappearance of symptoms in 34.5% of cases (N = 57) persistence of symptoms in 22.42% of cases (N = 37). Conclusion: In our study the prevalence of Helicobacter pylori infection in patients with functional dyspepsia is high: 70%. Sequential therapy is better than the standard triple therapy in the eradication of HP in patients with nonulcer dyspepsia, which improves their symptoms in more than 50% of cases.
Cite this paper: Adadi, S. , Bennani, B. , Elabkari, M. , Ibrahimi, A. , Alaoui, S. , El Khadir, M. , Harmouch, T. , Mahmoud, M. , Nejjari, C. and Benajah, D. (2018) Prevalence of Helicobacter pylori and the Interest of Its Eradication during the Functional Dyspepsia. Journal of Biosciences and Medicines, 6, 43-51. doi: 10.4236/jbm.2018.610006.

[1]   Agreus, L., Borgquist, L. (2002) The Cost of Gastro-Oesophageal Reflux Disease, Dyspepsia and Peptic Ulcer Disease in Sweden. PharmacoEconomics, 20, 347-355.

[2]   Quartero, A.O., Numans, M.E., Post, M.W.M., et al. (2002) One-Year Prognosis of Primary Care Dyspepsia: Predictive Value of Symptom Pattern, Helicobacter pylori and GP Management. European Journal of Gastroenterology & Hepatology, 14, 55-60.

[3]   Voiosu, T.A., et al. (2013) Functional Dyspepsia Today. Maedica, 8, 68-74.

[4]   Talley, N.J. and Choung, R.S. (2009) Whither Dyspepsia? A Historical Perspective of Functional Dyspepsia, and Concepts of Pathogenesis and Therapy in 2009. Journal of Gastroenterology and Hepatology, 24, S20-S28.

[5]   Sanders, M.K. and Peura, D.A. (2002) Helicobacter pylori-Associated Diseases. Current Gastroenterology Reports, 4, 448-454.

[6]   Xu, S., et al. (2013) Symptom Improvement after Helicobacter pylori Eradication in Patients with Functional Dyspepsia—A Multicenter, Randomized, Prospective Cohort Study. International Journal of Clinical and Experimental Medicine, 6, 747-756.

[7]   Moayyedi, P., Soo, S., Deeks, J., et al. (2006) Eradication of Helicobacter pylori for Non-Ulcer Dyspepsia. Cochrane Database of Systematic Reviews, No. 2, Article ID: CD002096.

[8]   Everhart, J.E. (2000) Recent Developments in the Epidemiology of Helicobacter pylori. Gastroenterology Clinics of North America, 29, 559-578.

[9]   Lacy, B.E. and Rosemore, J. (2001) Helicobacter pylori: Ulcers and More: The Beginning of an Era. Journal of Nutrition, 131, 2789S-2793S.

[10]   Armstrong, D. (1996) Helicobacter pylori Infection and Dyspepsia. Scandinavian Journal of Gastroenterology, 215, 38-47.

[11]   Jiao, Y., et al. (2013) Gastrointestinal Symptoms and Associated Factors in Chinese Patients with Functional Dyspepsia. World Journal of Gastroenterology, 19, 5357-5364.

[12]   Budavari, A.I. and Olden, K.W. (2003) Psychosocial Aspects of Functional Gastrointestinal Disorders. Gastroenterology Clinics of North America, 32, 477-506.

[13]   Aro, P., Talley, N.J., Ronkainen, J., et al. (2009) Anxiety Is Associated with Uninvestigated and Functional Dyspepsia (Rome III Criteria) in a Swedish Population Based Study. Gastroenterology, 137, 94-100.

[14]   Hashash, J.G., Abdul-Baki, H., Azar, C., et al. (2008) Clinical Trial: A Randomized Controlled Cross over Study of Flupenthixol + Melitracen Infunctional Dyspepsia. Alimentary Pharmacology & Therapeutics, 27, 1148-1155.

[15]   Loyd, R.A. and McClellan, D.A. (2011) Update on the Evaluation and Management of Functional Dyspepsia. American Family Physician, 83, 547-552.

[16]   Danesh, J., Lawrence, M., Murphy, M., et al. (2000) Systematic Review of the Epidemiological Evidence on Helicobacter Pylori Infection and Nonulcer or Uninvestigated Dyspepsia. Archives of Internal Medicine, 160, 167-180.

[17]   McColl, K., et al. (1998) Symptomatic Benefit from Eradicating Helicobacter pylori Infection in Patients with Nonulcerdyspepsia. The New England Journal of Medicine, 339, 1869-1874.

[18]   Blum, A., Talley, N., O’Morain, C., van Zanten, S.V., Labenz, J., Stolte, M., et al. (1998) Lack of Effect of Treating Helicobacter pylori Infection in Patients with Nonulcer Dyspepsia. The New England Journal of Medicine, 339, 1875-1881.

[19]   Talley, N.J., Vakil, N., Ballard, E.D. and Fennerty, M.B. (1999) Absence of Benefit of Eradicating Helicobacter pylori in Patients with Nonulcer Dyspepsia. The New England Journal of Medicine, 341, 1106-1111.

[20]   Ladrón de Guevara, L., Pena-Alfaro, N.G., Padilla, L., Lichtinger, A., Figueroa, S., Shapiro, I., et al. (2004) Evaluation of Symptomatology and Quality of Life in Functional Dyspepsia before and after Helicobacter pylori Eradication Treatment. Revista de Gastroenterología de México, 69, 203-208.

[21]   Longstreth, G.F. (2006) Functional Dyspepsia-Managing the Conundrum. The New England Journal of Medicine, 354, 791-793.

[22]   Harvey, R.F., et al. (2010) Clinical Trial: Prolonged Beneficial Effect of Helicobacter pylori Eradication on Dyspepsia Consultations. The Bristol Helicobacter Project. Alimentary Pharmacology & Therapeutics, 32, 394-400.

[23]   Talley, N.J. and Vakil, N. (2005) Practice Parameters Committee of the American College of Gastroenterology. Guidelines for the Management of Dyspepsia. The American Journal of Gastroenterology, 100, 2324-233.

[24]   Kim, S.E., et al. (2013) Effect of Helicobacter pylori Eradication on Functional Dyspepsia. Journal of Neurogastroenterology and Motility, 19, 233-243.

[25]   Miwa, H., et al. (2011) Current Understanding of Pathogenesis of Functional Dyspepsia. Journal of Gastroenterology and Hepatology, 26, 53-60.

[26]   Van Oudenhove, L., et al. (2008) Determinants of Symptoms in Functional Dyspepsia: Gastric Sensorimotor Function, Psychosocial Factors or Somatisation? Gut, 57, 1666-1673.

[27]   Ford, A.C., et al. (2005) Helicobacter pylori “Test and Treat” or Endoscopy for Managing Dyspepsia: An Individual Patient Data Meta-Analysis. Gastroenterology, 128, 1838-1844.