Original Article
Absence of Benefit of Eradicating Helicobacter pylori in Patients with Nonulcer Dyspepsia
N Engl J Med 1999; 341:1106-1111October 7, 1999
- Abstract
Background
The relation between Helicobacter pylori infection and nonulcer dyspepsia is uncertain. We tested the hypothesis that curing the infection will relieve symptoms of dyspepsia.
Methods
We randomly assigned 170 H. pylori–infected patients with nonulcer dyspepsia to receive twice-daily treatment with 20 mg of omeprazole, 1000 mg of amoxicillin, and 500 mg of clarithromycin for 14 days and 167 such patients to receive identical-appearing placebos; all patients were then followed through regular visits for 12 months. Symptoms were scored on diary cards for seven days before each visit. A carbon-13 urea breath test was performed at base line and repeated at 1 and 12 months, and endoscopic biopsy was performed at 12 months to determine H. pylori status. Treatment was considered successful if the patient had only mild pain or discomfort or none at all.
Results
The rate of eradication of H. pylori infection was 90 percent in the active-treatment group and 2 percent in the placebo group at four to six weeks (P<0.001). At 12 months, there was no significant difference between groups in the rate of successful treatment (46 percent in the active-treatment group and 50 percent in the placebo group; relative likelihood of success with active treatment, 0.93; 95 percent confidence interval, 0.73 to 1.18; P=0.56). There was also no significant difference in the rate of successful treatment at 12 months between patients who were H. pylori–negative and those who were H. pylori–positive (48 percent vs. 49 percent). The rates of successful treatment were also similar when patients were analyzed according to the type of dyspepsia (ulcer-like, reflux-like, or dysmotility-like) and changes in the quality of life. There was no significant association between treatment success and histologic improvement in chronic gastritis at 12 months (P=0.68).
Conclusions
We found no evidence that curing H. pylori infection in patients with nonulcer dyspepsia leads to relief of symptoms.
Media in This Article
Figure 1
Mean Dyspepsia Symptom Scores Recorded on Diary Cards by the Patients during the Week before Each Visit, According to the Intention to Treat.Table 1
Base-Line Characteristics of the 293 Patients Included in the Intention-to-Treat Analysis.Article Activity
- Article
Dyspepsia refers to pain or discomfort centered in the upper abdomen.1 Dyspepsia may indicate the presence of serious disease, such as peptic ulcer or gastric cancer.2,3 However, the most frequent type is nonulcer dyspepsia, in which no definite structural or biochemical explanation for the symptoms can be identified.4-6
At least 50 percent of patients with dyspepsia who are seen in primary care settings have nonulcer dyspepsia.4,5 The discovery of Helicobacter pylori has resulted in important advances in the management of dyspepsia. It is now accepted that peptic ulcer is causally linked to the infection and that all patients who have ulcers and H. pylori infection should receive therapy to eradicate the diathesis.7-11 However, although approximately 30 percent of patients with nonulcer dyspepsia also have H. pylori infection,2-6 it is controversial whether they should receive antibacterial treatment. In 1994, a National Institutes of Health consensus conference recommended against the use of therapy for H. pylori infection in patients with nonulcer dyspepsia because of a lack of evidence of benefit.7 More recently, other expert groups in North America, Europe, and Australasia have cautiously, but not unanimously, endorsed treating such patients on a case-by-case basis.8-11 The older clinical studies of the treatment of H. pylori in patients with nonulcer dyspepsia had contradictory results and were often methodologically flawed.12 Two recent European trials were well designed but also reached conflicting conclusions.13,14
We conducted a study in the United States to determine the effect of eradicating H. pylori infection in patients with nonulcer dyspepsia. Since chronic gastritis may take a long while to resolve after the eradication of H. pylori, 15 we followed our patients for 12 months.
Methods
Patients
Between July 1996 and March 1998, consecutive patients in the United States who were 18 to 65 years of age were invited to participate if they had had at least moderate pain or discomfort (or both) centered in the upper abdomen as their predominant symptom1 for a minimum of three days in the week before randomization; had had dyspepsia for at least three months; and had normal endoscopic findings in the esophagus, stomach, and duodenum. Patients with reflux esophagitis, Barrett's esophagus, chronic gastric or duodenal ulceration, duodenal or esophageal erosions, or cancer and those with more than five gastric erosions on upper endoscopy were excluded. Patients who predominantly had heartburn or symptoms of the irritable bowel syndrome were also excluded. Ongoing treatment with a histamine H2-receptor antagonist, a prostaglandin, or a prokinetic drug during the 7 days before enrollment was not permitted, nor was treatment with a proton-pump inhibitor, an antibiotic, or bismuth in the 30 days before enrollment. Similarly, patients with a history of peptic ulcer or gastroesophageal reflux (on the basis of endoscopy or 24-hour testing of esophageal pH) were excluded, as were those with potentially serious symptoms such as unintentional weight loss. Occasional use of nonsteroidal antiinflammatory drugs (fewer than five days per month) or low-dose aspirin was allowed. The study protocol was approved by the applicable institutional review boards at all study sites, and written informed consent was obtained from all patients.
Study Design
At base line, patients were screened for H. pylori with use of a carbon-13 urea breath test according to a standard, validated protocol in a central laboratory (Meretek Diagnostics, Houston). The results were considered positive if the value at 30 minutes was more than 2.4 U above the base-line value.16 The patients then filled out diary cards during a seven day run-in period. No study medication was dispensed during the run-in period.
Patients who had a positive urea breath test and symptoms of dyspepsia during the run-in period underwent endoscopy the day before randomization. Patients were randomly assigned according to a computer-generated randomization list (1:1) to receive either twice-daily treatment with 20 mg of omeprazole (Prilosec, Astra Merck, Wayne, Pa.), 1000 mg of amoxicillin, and 500 mg of clarithromycin (Biaxin, Abbott Laboratories, Abbott Park, Ill.) for 14 days or twice-daily treatment with identical-appearing placebos. Neither the investigators nor the patients were aware of the treatment assignments.
The patients returned 4 to 6 weeks and 3, 6, 9, and 12 months after the cessation of treatment. Diary cards were completed the week before each visit and then collected. Adverse events were recorded, and compliance was assessed by tablet count. Urea breath testing was performed at 4 to 6 weeks and at 12 months; upper endoscopy and biopsy were also performed at the 12-month visit. An antacid with a weak neutralizing capacity (aluminum hydroxide, magnesium hydroxide, and simethicone; Gelusil, Parke-Davis, Morris Plains, N.J.) was dispensed at each visit during the year of follow-up, and the use of this agent was recorded.
Assessment of Dyspepsia
Symptoms of dyspepsia were assessed with diary cards and the Gastrointestinal Symptom Rating Scale.17 Each day, patients recorded their worst symptoms of dyspepsia on diary cards according to a four-point scale in which a score of 0 indicated no pain or discomfort, a score of 1 mild pain or discomfort, a score of 2 moderate (annoying but not interfering with the daily routine) pain or discomfort, and a score of 3 severe (markedly interfering with the daily routine) pain or discomfort. This scale is reliable, valid, and responsive and provides global assessment of symptoms.18
The Gastrointestinal Symptom Rating Scale, a validated 15-item instrument that includes seven graded scales, was used retrospectively to assess symptoms that had occurred during the preceding week. The scores on this test can range from 0 (no symptoms) to 6 (very severe symptoms).17 Using the Gastrointestinal Symptom Rating Scale, we classified the patients according to the type of symptoms: ulcer-like dyspepsia, defined as the presence of at least moderate stomach pain and hunger pain in the week before a visit; dysmotility-like dyspepsia, defined as the occurrence of two or more episodes of at least moderate bloating, nausea, stomach rumbling, or belching in the week before a visit; and reflux-like dyspepsia, defined as the presence of at least moderate heartburn or acid regurgitation in the week before a visit. None of the subgroups were mutually exclusive.
Histologic Assessment
Two biopsy specimens were obtained from the antrum and body of the stomach and examined by an experienced histopathologist who was unaware of the patients' treatment assignments. The corpus specimens were obtained 6 to 7 cm from the cardia along the greater curvature. The antral specimens were obtained from the anterior and posterior walls, 2 cm proximal to the pylorus. All samples were stained with Genta stain.19 The specimens were classified as indicating the presence of active or chronic gastritis. In specimens with active gastritis, the histologic findings were graded as follows: no polymorphonuclear cells, a score of 0; rare polymorphonuclear cells, only in lamina propria, a score of 1; less than 1 intraepithelial polymorphonuclear cell per high-power field, a score of 2; 1 to 10 intraepithelial polymorphonuclear cells per high-power field, a score of 3; more than 10 intraepithelial polymorphonuclear cells per high-power field, a score of 4; and pit abscesses, a score of 5. In specimens with chronic gastritis, the histologic findings were graded as follows: scattered mononuclear cells that were not adjacent to lymphocytes and plasma cells, a score of 0; a slight increase in the thickness of the lamina propria, a score of 1; a definite increase in subepithelial areas of the lamina propria, a score of 2; an increase in all areas of the lamina propria, a score of 3; an increase in the thickness of the lamina propria and in the number of intraepithelial lymphocytes, a score of 4; and obliteration of the lamina propria, a score of 5.
Status at 12 Months
If the urea breath test, the histologic analysis, or both were positive at 12 months, the patient was considered to be H. pylori–positive. If both tests were negative, then H. pylori was not considered to be present. If a patient had only one negative test available or had taken antimicrobial agents before the assessment, thus confounding the interpretation of these tests, his or her H. pylori status was considered indeterminate.
Assessment of the Quality of Life
The patients' quality of life was assessed at base line and at the 12-month follow-up visit with use of the validated 36-item Medical Outcomes Study Short-Form General Health Survey (SF-36).20 This instrument assesses eight aspects of the quality of life: physical function, pain, general health, vitality, social function, physical health, emotional health, and mental health. Scores on each of these aspects can range from 0 (worst) to 100 (best). A change of 5 points is considered clinically significant.21,22
Statistical Analysis
The study was designed to enroll 335 patients and have 270 patients in the efficacy analyses (i.e., >80 percent). This number of patients would provide the study with the ability to detect a 20 percent difference in 12-month success rates with a power of 88 percent. The rate of symptom relief in the placebo group was assumed to be 40 percent.
Treatment was considered successful if a patient reported having no more than mild pain or discomfort centered in the upper abdomen (a score of 0 or 1) during the 7 days before the final (12-month) visit on the daily diary card. Treatment was considered to have failed if a patient had taken medication for dyspepsia (other than antacids) in the 30 days before the 12-month visit.
For patients whose symptoms were not assessed at 12 months but whose symptoms had been assessed at the 4-to-6-week visit or afterward, the most recent results were used for the 12-month values. Symptom relief was compared in the two groups with use of Fisher's exact test.23 Each symptom included in the Gastrointestinal Symptom Rating Scale and each aspect of the SF-36 was analyzed with the use of descriptive statistics. The mean change in scores between the two groups was compared with use of analysis of variance.24 Missing scores were imputed for the SF-36 if at least 50 percent of the questions in that portion had been answered by the patient.22 The number of antacid tablets taken between visits was analyzed with the use of descriptive statistics and Fisher's exact test.23
Chronic gastritis was considered to be healed if both antral and corpus specimens had an inflammation score of 0 or 1.19 Active gastritis was considered to be healed if the score was 0.19 Patients who did not undergo endoscopy after randomization were excluded. Fisher's exact test was used to compare healing of gastritis in the two treatment groups.23 All P values were two-tailed.
Results
Base-Line Characteristics of the Patients
We screened 640 patients and excluded 303: 54 had abnormal findings on endoscopy, 3 did not complete their diaries, 131 were negative for H. pylori, 34 had minimal symptoms, 12 declined to provide consent, and 69 had other underlying conditions. A total of 170 patients (74 of them men) were randomly assigned to receive omeprazole, amoxicillin, and clarithromycin, and 167 (77 of them men) were assigned to receive placebo. The mean number of patients recruited at each center was 6 (range, 1 to 42). A total of 150 patients in the active-treatment group and 143 in the placebo group were included in the intention-to-treat analysis. Excluded were patients who had a positive urea breath test but who were negative for H. pylori at base line according to histologic assessment and a urease slide test (CLO test, Delta West, Bentley, Australia) (4 in the active-treatment group and 3 in the placebo group), a disqualifying dyspepsia score at base line that was overlooked by the investigator (4 in the active-treatment group and 9 in the placebo group), or no data after randomization (12 in each group). The two groups were well balanced with respect to demographic and clinical features; only the prevalences of caffeine use and a family history of ulcer were higher in the active-treatment group (Table 1Table 1
Base-Line Characteristics of the 293 Patients Included in the Intention-to-Treat Analysis.).Eradication of H. pylori Infection and Healing of Gastritis
Urea breath testing showed that 90 percent of the patients in the active-treatment group (121 of 135) were negative for H. pylori at four to six weeks (data were incomplete for 7 patients), as compared with 2 percent of the patients in the placebo group (3 of 139, P<0.001). At 12 months, the rates were 80 percent (78 of 98; 19 indeterminate) and 5 percent (6 of 119), respectively, on the basis of histologic assessment and urea breath testing (P<0.001). According to an intention-to-treat analysis (excluding those with missing or inadequate data), 86 percent of the patients in the active-treatment group (95 of 110) had complete resolution of active (polymorphonuclear cell) gastritis (grade 0) at 12 months, as compared with 8 percent of the patients in the placebo group (9 of 114, P<0.001). Similarly, 67 percent of the patients in the active-treatment group (74 of 110) had an improvement in chronic (mononuclear cell) gastritis (grade 0 or 1), as compared with 18 percent of the patients in the placebo group (21 of 114, P<0.001).
Compliance with treatment was excellent, with 94 percent of the patients in each group taking at least 90 percent of the 28 doses. Only 4 percent of patients in the active-treatment group and none of those in the placebo group discontinued treatment because of adverse events; 10 percent of the patients in the active-treatment group had a disturbance in taste, as compared with none of those in the placebo group; the respective rates of diarrhea were 11 percent and 5 percent.
Relief of Symptoms
According to the intention-to-treat analysis, at 12 months, treatment was successful (defined as the presence of no more than mild pain or discomfort) in 46 percent of the patients in the active-treatment group (69 of 150) and 50 percent of those in the placebo group (71 of 142, P=0.56) (Table 2Table 2
Primary and Secondary Outcomes at 12 Months.). The rate of treatment success among patients who were H. pylori–negative at 12 months was 48 percent (59 of 124), as compared with 49 percent among those who were H. pylori–positive (73 of 150, P=0.90). There was no significant difference in mean symptom scores between the two treatment groups (Figure 1Figure 1Mean Dyspepsia Symptom Scores Recorded on Diary Cards by the Patients during the Week before Each Visit, According to the Intention to Treat.) at any point during follow-up.The mean rate of antacid use at 12 months was 5.7 tablets per week in the active-treatment group and 5.2 tablets per week in the placebo group (P=0.74). The use of other gastrointestinal drugs during the 12 months of follow-up was similar in the two groups: H2-receptor antagonists were taken by 14 percent of the patients in the active-treatment group and 15 percent of those in the placebo group; proton-pump inhibitors were taken by 4 percent and 3 percent, respectively; bismuth by 1 percent and 1 percent; and prokinetic drugs by 1 percent and less than 1 percent.
In the group with ulcer-like dyspepsia, treatment was successful at 12 months in 41 percent of the patients who received active treatment (54 of 131) and 48 percent of the patients who received placebo (59 of 122). The corresponding rates were 42 percent and 49 percent in the group with dysmotility-like dyspepsia and 40 percent and 48 percent in the group with reflux-like dyspepsia.
The SF-36 scores are summarized in Table 3Table 3
Quality of Life According to the Mean Scores on the 36-Item Medical Outcomes Study Short-Form General Health Survey.. At 12 months, the only significant differences between groups were in the scores for physical health, which were better in the placebo group, and for emotional health, which were better in the active-treatment group. However, most of the differences in the scores at 12 months were small and were not clinically significant.Outcome among Patients with Chronic Gastritis
Patients with chronic gastritis were subdivided regardless of treatment into those with a score of 0 or 1 (no gastritis or mild gastritis) and those with a score of 2, 3, 4, or 5 (moderate or severe gastritis). At the 12-month follow-up visit, treatment was considered to have been successful in 54 percent of the patients with a score of 0 or 1 (14 of 26), as compared with 49 percent of the patients with a score of 2, 3, 4, or 5 (99 of 201, P=0.68).
Development of Peptic Ulcer
At the 12-month follow-up visit, a duodenal ulcer had developed in 2 percent of the patients in the active-treatment group (3 of 170), as compared with 4 percent of those in the placebo group (7 of 167, P=0.22). The rate of development of gastric ulcers during follow-up was the same in the two groups (2 percent).
Discussion
We tested the hypothesis that H. pylori is a cause of nonulcer dyspepsia but found no convincing evidence that eradication of this infection cures the disorder. Complete relief of symptoms at 12 months, for example, occurred in 28 percent of the patients who received omeprazole and antibiotics and 23 percent of those who received placebo. The results of assessments of other outcomes of dyspepsia were similar. Active treatment was not associated with a clinically significant improvement in the quality of life.
There have been a number of relatively small studies of the effect of the eradication of H. pylori infection on nonulcer dyspepsia, but most have had design limitations.7-12 In particular, many studies with a negative outcome were very small.12,15,25 Recently, well-designed, larger trials have reported conflicting results. McColl et al. conducted a single-center, randomized, placebo-controlled study of 318 patients in Scotland.14 Triple therapy with omeprazole, amoxicillin, and metronidazole was compared with therapy with omeprazole alone for 1 week, with 12 months of follow-up. At one year, dyspepsia had resolved in 21 percent of the patients in the triple-therapy group, compared with 7 percent of the patients in the group given omeprazole alone — a significant difference. The results suggested that one in five patients with nonulcer dyspepsia will benefit from eradication therapy. Two factors — the high background rate of ulcer disease in the population from which the patients were recruited and the fact that endoscopic follow-up was not routinely performed — may in part explain the low rate of response to placebo, since patients in whom ulcer was misdiagnosed as nonulcer dyspepsia would be more likely to become symptomatic.
Other predominantly European multicenter trials have reached different conclusions. Blum et al. randomly assigned 348 patients to receive triple therapy with omeprazole, amoxicillin, and clarithromycin or therapy with omeprazole alone for one week; the patients were then followed for a year.13 Treatment was successful in 27 percent of the patients in the triple-therapy group and 21 percent of those in the placebo group — a difference that was not significant. Similarly, Talley et al. randomly assigned 275 patients to receive triple therapy with omeprazole, clarithromycin, and amoxicillin or placebo alone for one week.26 At one year, 24 percent of the patients in the active-treatment group and 21 percent of those in the placebo group had relief of dyspepsia — also not a significant difference.26
In our study, the active-treatment group had a higher rate of response than did the triple-therapy groups in the European studies, presumably because of the primary outcome measure used, but the rate of response was similar in the placebo group. The rate of response to placebo did not decline during the 12 months of follow-up in our study despite the requirement that patients have symptoms of chronic disease before entry. One study with otherwise negative results reported that patients with resolution of gastritis were significantly more likely to have symptom relief than those who had persistent inflammation 12 months after triple therapy or placebo, although this finding was based on a secondary analysis.26 We found, however, no association between histologic improvement in gastritis and relief of symptoms of dyspepsia, suggesting that the previous observations represent chance findings.
In conclusion, we assessed the clinical benefits of the eradication of H. pylori infection in patients with nonulcer dyspepsia in a randomized, double-blind, placebo-controlled study. We found no evidence that eradicating the infection leads to relief of symptoms 12 months after treatment.
Supported by Abbott Laboratories and Astra Merck, USA.
Dr. Talley has been a consultant for Abbott Laboratories and Astra Hässle and has had research grants from Astra Hässle. Dr. Vakil has been a consultant for Abbott, Korea. Drs. Vakil and Fennerty have had research grants from Astra Merck and Abbott Laboratories. After the completion of the study, Dr. Ballard became medical director of the Molecular Therapeutics Division at Abbott Laboratories.
We are indebted to the following investigators for recruiting patients for the study: Richard Baerg, Tacoma, Wash.; Charles Barish, Raleigh, N.C.; Marcelo Barreiro, Binghamton, N.Y.; William Berry, Longmont, Colo.; Charles Birbara, Worcester, Mass.; Timothy Brady, St. Louis; Craig Brayko, Great Falls, Mont.; Stuart P. Brogadin, Manchester, N.H.; Antonio Caos, Ocoee, Fla.; Stuart Chen, Kansas City, Mo.; Yang K. Chen, Loma Linda, Calif.; Richard Cline, Maryville, Tenn.; Dale Collins, Arvada, Colo.; Michael DeMicco, Anaheim, Calif.; Mark Eisner, Zephyrhills, Fla.; Roy Ferguson, Cleveland; Duane D. Fitch, Wilson, N.C.; Edwin Flanagan, Port St. Lucie, Fla.; Greg Fusilier, Baton Rouge, La.; David S. James, Tulsa, Okla.; Bruce Johnson, San Diego, Calif.; David G. Kogut, Statesville, N.C.; Robert Kornfield, Rochester, N.Y.; Thomas Kovacs, Los Angeles; Daniel Kruss, Oak Park, Ill.; Frank Lanza, Houston; Scott Levenson, Redwood City, Calif.; Michael LeVine, Marietta, Ga.; Kathleen Martin, Lexington, Ky.; Hooshang Meshkinpour, Orange, Calif.; Philip Miner, Oklahoma City; Rao Movva, Moline, Ill.; Frederick Opper, Wilmington, N.C.; Daniel Pambianco, Charlottesville, Va.; David A. Peura, Charlottesville, Va.; Ron E. Pruitt, Nashville; Francisco Ramirez, Phoenix, Ariz.; Alvaro Reymunde, Ponce, P.R.; Fred B. Rosenberg, Waukegan, Ill.; Herbert Rubin, Beverly Hills, Calif.; Seymour M. Sabesin, Chicago; Michael Safdi, Cincinnati; Bruce Sahba, San Diego, Calif.; Tim Schubert, Tacoma, Wash.; Howard Schwartz, Miami; U.K. Shah, Hollywood, Md.; Morris V. Shelanski, Conshohocken, Pa.; B.N. Shivakumar, Davenport, Iowa; David R. Silvers, Metairie, La.; Timothy Simmons, Inglewood, Calif.; Manual Sklar, Bingham Farms, Mich.; Roger D. Soloway, Galveston, Tex.; Stephen Sontag, Hines, Ill.; Malcolm Sperling, Fountain Valley, Calif.; Scott Wiesen, Naples, Fla.; Barry Winston, Houston; and Lawrence Wruble, Memphis, Tenn.
Source Information
From the Department of Medicine, University of Sydney, Nepean Hospital, Penrith, Australia (N.J.T.); University of Wisconsin Medical School, Milwaukee (N.V.); the Department of Family Medicine, Bethesda Hospital, Cincinnati (E.D.B.); and Oregon Health Sciences University, Portland (M.B.F.).
Address reprint requests to Dr. Talley at the Department of Medicine, University of Sydney, Nepean Hospital, Clinical Sciences Bldg., Penrith, NSW 2751, Australia, or at talley@pnc.com.au.
- References
References
1
Talley NJ ,Colin-Jones D ,Koch KL ,Koch M ,Nyren O ,Stanghellini V . Functional dyspepsia: a classification with guidelines for diagnosis and management. Gastroenterol Int 1991;4:145-1602
Bernersen B ,Johnsen R ,Bostad L ,Straume B ,Sommer AI ,Burhol PG . Is Helicobacter pylori the cause of dyspepsia? BMJ 1992;304:1276-1279
CrossRef | Web of Science | Medline3
Armstrong D . Helicobacter pylori infection and dyspepsia. Scand J Gastroenterol Suppl 1996;215:38-47
CrossRef | Medline4
Richter JE . Dyspepsia: organic causes and differential characteristics from functional dyspepsia. Scand J Gastroenterol Suppl 1991;182:11-16
CrossRef | Medline5
Heikkinen M ,Pikkarainen P ,Takala J ,Rasanen H ,Julkunen R . Etiology of dyspepsia: four hundred unselected consecutive patients in general practice. Scand J Gastroenterol 1995;30:519-523
CrossRef | Web of Science | Medline6
Klauser AG ,Voderholzer WA ,Knesewitsch PA ,Schindlbeck NE ,Muller-Lissner SA . What is behind dyspepsia? Dig Dis Sci 1993;38:147-154
CrossRef | Web of Science | Medline7
NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease
CrossRef | Web of Science8
American Gastroenterological Association medical position statement: evaluation of dyspepsia
CrossRef | Web of Science | Medline9
Hunt RH ,Thompson ABR . Canadian Helicobacter pylori consensus conference. Can J Gastroenterol 1998;12:31-41
Web of Science | Medline10
Malfertheiner P ,Megraud F ,O'Morain C , et al. Current European concepts in the management of Helicobacter pylori infection -- the Maastricht Consensus report. Eur J Gastroenterol Hepatol 1997;9:1-2
Web of Science | Medline11
Lam SK ,Talley NJ . Report of the 1997 Asia Pacific Consensus Conference on the management of Helicobacter pylori infection. J Gastroenterol Hepatol 1998;13:1-12
CrossRef | Web of Science | Medline12
Talley NJ . A critique of therapeutic trials in Helicobacter pylori-positive functional dyspepsia. Gastroenterology 1994;106:1174-1183
Web of Science | Medline13
Blum AL ,Talley NJ ,O'Morain C , et al. Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med 1998;339:1875-1881
Full Text | Web of Science | Medline14
McColl KEL ,Murray LS ,El-Omar E , et al. Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia. N Engl J Med 1998;339:1869-1874
Full Text | Web of Science | Medline15
McCarthy C ,Patchett S ,Collins RM ,Beattie S ,Keane C ,O'Morain C . Long-term prospective study of Helicobacter pylori in nonulcer dyspepsia. Dig Dis Sci 1995;40:114-119
CrossRef | Web of Science | Medline16
Malaty HM ,el-Zimaity HM ,Genta RM ,Klein PD ,Graham DY . Twenty-minute fasting version of the US 13C-urea breath test for the diagnosis of H. pylori infection. Helicobacter 1996;1:165-167
CrossRef | Medline17
Svedlund J ,Sjodin I ,Dotervall G . GSRS -- a clinical rating scale for gastrointestinal symptoms in patients with irritable bowel syndrome and peptic ulcer disease. Dig Dis Sci 1988;33:129-134
CrossRef | Web of Science | Medline18
Talley NJ ,Meineche-Schmidt V ,Pare P , et al. Efficacy of omeprazole in functional dyspepsia: a double-blind, randomized, placebo-controlled trial. Aliment Pharmacol Ther 1998;12:1055-1065
CrossRef | Web of Science | Medline19
Dixon MF ,Genta RM ,Yardley JH ,Correa P . Classification and grading of gastritis: the updated Sydney system. Am J Surg Pathol 1996;20:1161-1181
CrossRef | Web of Science | Medline20
Mant JW ,Jenkinson C ,Murphy MF ,Clipsham K ,Marshall P ,Vessey MP . Use of the Short Form-36 to detect the influence of upper gastrointestinal disease on self-reported health status. Qual Life Res 1998;7:221-226
CrossRef | Web of Science | Medline21
Leidy NK ,Revicki DA ,Genente B . Recommendations for evaluating the validity of quality of life claims for labeling and promotion. Value Health 1999;2:113-127
CrossRef | Medline22
Ware JE Jr, Snow KK, Kosinski M, Gandek B. SF-36 health survey: manual and interpretation guide. Boston: The Health Institute, New England Medical Center, 1993.
23
Agresti A. Categorical data analysis. New York: Wiley, 1990.
24
Searle SR. Linear models. New York: Wiley, 1971.
25
Veldhuyzen van Zanten SJO ,Cleary C ,Talley NJ , et al. Drug treatment of functional dyspepsia: a systematic analysis of trial methodology with recommendations for design of future trials. Am J Gastroenterol 1996;91:660-673
Web of Science | Medline26
Talley NJ ,Janssens J ,Lauritsen K ,Racz I ,Bolling-Sternevald E . Eradication of Helicobacter pylori in functional dyspepsia: randomised double blind placebo controlled trial with 12 months' follow up. BMJ 1999;318:833-837
CrossRef | Web of Science | Medline
- Citing Articles (128)
Citing Articles
1
Nicholas J. Talley, G. Richard Locke, Linda M. Herrick, Vickie M. Silvernail, Charlene M. Prather, Brian E. Lacy, John K. DiBaise, Colin W. Howden, Darren M. Brenner, Ernest P. Bouras, Hashem B. El-Serag, Bincy P. Abraham, Paul Moayyedi, Alan R. Zinsmeister. (2012) Functional Dyspepsia Treatment Trial (FDTT): A double-blind, randomized, placebo-controlled trial of antidepressants in functional dyspepsia, evaluating symptoms, psychopathology, pathophysiology and pharmacogenetics. Contemporary Clinical Trials
CrossRef2
Hidekazu Suzuki, Toshihiro Nishizawa, Toshifumi Hibi. (2011) Can Helicobacter pylori-associated dyspepsia be categorized as functional dyspepsia?. Journal of Gastroenterology and Hepatology 26, 42-45
CrossRef3
Paul Moayyedi, Jose Santana, Mostafiz Khan, Cathy Preston, Clare Donnellan, Paul Moayyedi. 2011. Medical treatments in the short term management of reflux oesophagitis. .
CrossRef4
Paul Moayyedi, Shelly Soo, Jonathan J Deeks, Brendan Delaney, Adam Harris, Michael Innes, R Oakes, Sue Wilson, A Roalfe, Cathy Bennett, David Forman, Paul Moayyedi. 2011. Eradication of Helicobacter pylori for non-ulcer dyspepsia. .
CrossRef5
Kentaro Sugano. (2011) Should We Still Subcategorize Helicobacter pylori -Associated Dyspepsia as Functional Disease?. Journal of Neurogastroenterology and Motility 17:4, 366
CrossRef6
Anke Mark, Michael Spallek, David A. Groneberg, Richard Kessel, Stephan W. Weiler. (2010) Correlates shift work with increased risk of gastrointestinal complaints or frequency of gastritis or peptic ulcer in H. pylori-infected shift workers?. International Archives of Occupational and Environmental Health 83:4, 423-431
CrossRef7
Tseng-Shing Chen, Jiing-Chyuan Luo, Full-Young Chang. (2010) Psychosocial-spiritual factors in patients with functional dyspepsia: a comparative study with normal individuals having the same endoscopic features. European Journal of Gastroenterology & Hepatology 22:1, 75-80
CrossRef8
Xiao Bo LI, Hui Min CHEN, Hong LU, Qing ZHENG, Xiao Yu CHEN, Yan Shen PENG, Zhi Zheng GE, Wen Zhong LIU. (2009) Role of Helicobacter pylori infection on neuronal expression in the stomach and spinal cord of a murine model. Journal of Digestive Diseases 10:4, 286-292
CrossRef9
Aamir Saleem, Asghar Qasim, Humphrey J O’Connor, Colm A O’Morain. (2009) Pylera ® for the eradication of Helicobacter pylori infection. Expert Review of Anti-infective Therapy 7:7, 793-799
CrossRef10
Kok-Ann Gwee, Leyan Teng, Reuben-KM Wong, Khek-Yu Ho, Dede-Selamat Sutedja, Khay-Guan Yeoh. (2009) The response of Asian patients with functional dyspepsia to eradication of Helicobacter pylori infection. European Journal of Gastroenterology & Hepatology 21:4, 417-424
CrossRef11
Ebru Turkkan, Ihsan Uslan, Gursel Acarturk, Nevin Topak, Ahmet Kahraman, Fatma Husniye Dilek, Yusuf Akcan, Ozcan Karaman, Mehmet Colbay, Seref Yuksel. (2009) Does Helicobacter pylori-induced inflammation of gastric mucosa determine the severity of symptoms in functional dyspepsia?. Journal of Gastroenterology 44:1, 66-70
CrossRef12
J. G. HASHASH, H. ABDUL-BAKI, C. AZAR, I. I. ELHAJJ, L. EL ZAHABI, H. F. CHAAR, A. I. SHARARA. (2008) Clinical trial: a randomized controlled cross-over study of flupenthixol + melitracen in functional dyspepsia. Alimentary Pharmacology & Therapeutics 27:11, 1148-1155
CrossRef13
Nimish Vakil, Loren Laine, Nicholas J. Talley, Salam F. Zakko, Jan Tack, William D. Chey, Jeffrey Kralstein, David L. Earnest, Gregory Ligozio, Marielle Cohard-Radice. (2008) Tegaserod Treatment for Dysmotility-Like Functional Dyspepsia: Results of Two Randomized, Controlled Trials. The American Journal of Gastroenterology???-???
CrossRef14
Tuba Esfandyari, Gavin C Harewood. (2007) Value of a negative colonoscopy in patients with non-specific gastrointestinal symptoms. Journal of Gastroenterology and Hepatology 22:10, 1609-1614
CrossRef15
William D. Chey, Benjamin C.Y. Wong, . (2007) American College of Gastroenterology Guideline on the Management of Helicobacter pylori Infection. The American Journal of Gastroenterology 102:8, 1808-1825
CrossRef16
Sisir Kumar Saha. (2007) Mucosal Plug in the Etiology of Peptic Ulcer Disease. Digestive Diseases and Sciences 52:8, 1867-1870
CrossRef17
Ulrike von Arnim, Ulrich Peitz, Bettina Vinson, Karl-Josef Gundermann, Peter Malfertheiner. (2007) STW 5, a Phytopharmacon for Patients With Functional Dyspepsia: Results of a Multicenter, Placebo-Controlled Double-Blind Study. The American Journal of Gastroenterology 102:6, 1268-1275
CrossRef18
Larry H. Lai, Joseph J.Y. Sung. (2007) Helicobacter pylori and benign upper digestive disease. Best Practice & Research Clinical Gastroenterology 21:2, 261-279
CrossRef19
Panagiotis Katsinelos, Kostas Tziomalos, Grigoris Chatzimavroudis, Themistoklis Vasiliadis, Taxiarchis Katsinelos, Ioannis Pilpilidis, Ioannis Triantafillidis, George Paroutoglou, Basilis Papaziogas. (2007) Eradication Therapy in <i>Helicobacter pylori</i>-Positive Patients with Halitosis: Long-Term Outcome. Medical Principles and Practice 16:2, 119-123
CrossRef20
Paul Moayyedi, Soo Shelly, Jonathan J Deeks, Brendan Delaney, Michael Innes, David Forman, Paul Moayyedi. 2006. Pharmacological interventions for non-ulcer dyspepsia. .
CrossRef21
Hidekazu Suzuki, Toshihiro Nishizawa, Toshifumi Hibi. (2006) Therapeutic strategies for functional dyspepsia and the introduction of the Rome III classification. Journal of Gastroenterology 41:6, 513-523
CrossRef22
T. SUZUKI, K. MATSUO, A. SAWAKI, H. ITO, K. HIROSE, K. WAKAI, S. SATO, T. NAKAMURA, K. YAMAO, R. UEDA, K. TAJIMA. (2006) Systematic review and meta-analysis: importance of CagA status for successful eradication of Helicobacter pylori infection. Alimentary Pharmacology and Therapeutics 24:2, 273-280
CrossRef23
N. VAKIL, N. J. TALLEY, M. STOLTE, M. SUNDIN, O. JUNGHARD, E. BOLLING-STERNEVALD. (2006) Patterns of gastritis and the effect of eradicating Helicobacter pylori on gastro-oesophageal reflux disease in Western patients with non-ulcer dyspepsia. Alimentary Pharmacology and Therapeutics 24:1, 55-63
CrossRef24
Dorte Ejg Jarbol, Mickael Bech, Jakob Kragstrup, Troels Havelund, Ove B. Schaffalitzky de Muckadell. (2006) Economic evaluation of empirical antisecretory therapy versus Helicobacter pylori for management of dyspepsia: A randomized trial in primary care. International Journal of Technology Assessment in Health Care 22:03,
CrossRef25
Tadayuki Oshima, Hiroto Miwa. (2006) Treatment of functional dyspepsia: where to go and what to do. Journal of Gastroenterology 41:7, 718-719
CrossRef26
Tiing Leong Ang, Kwong Ming Fock, Eng Kiong Teo, Yiong Huak Chan, Tay Meng Ng, Tju Siang Chua, Jessica Yi-Lyn Tan. (2006) Helicobacter pylori eradication versus prokinetics in the treatment of functional dyspepsia: a randomized, double-blind study. Journal of Gastroenterology 41:7, 647-653
CrossRef27
Paul Moayyedi, Shelly Soo, Jonathan J Deeks, Brendan Delaney, Adam Harris, Michael Innes, R Oakes, Sue Wilson, A Roalfe, Cathy Bennett, David Forman, Paul Moayyedi. 2006. Eradication of Helicobacter pylori for non-ulcer dyspepsia. .
CrossRef28
Anil Minocha, William Chad Wigington, William D. Johnson. (2006) Detailed Characterization of Epidemiology of Uninvestigated Dyspepsia and Its Impact on Quality of Life Among African Americans as Compared to Caucasians. The American Journal of Gastroenterology 101:2, 336-342
CrossRef29
HUCK JOO TAN, ABDUL MANAF RIZAL, MOHAMED-YUSOFF ROSMADI, KHEAN-LEE GOH. (2006) Role of Helicobacter pylori virulence factor and genotypes in non-ulcer dyspepsia. Journal of Gastroenterology and Hepatology 21:1, 110-115
CrossRef30
Luiz E. Mazzoleni, Guilherme B. Sander, Eduardo A. Ott, Sérgio G. S. Barros, Carlos F. Francesconi, Carisi A. Polanczyk, André C. Wortmann, Alexandro L. Theil, Leandro G. Fritscher, Luis F Rivero, André Cartell, Maria I. A. Edelweiss, Diego M. Uchôa, João C. Prolla. (2006) Clinical Outcomes of Eradication of Helicobacter pylori in Nonulcer Dyspepsia in a Population with a High Prevalence of Infection: Results of a 12-Month Randomized, Double Blind, Placebo-Controlled Study. Digestive Diseases and Sciences 51:1, 89-98
CrossRef31
Bruce E. Stabile, Brian R. Smith, David L. Weeks. (2005) Helicobacter pylori Infection and Surgical Disease—Part II. Current Problems in Surgery 42:12, 804-862
CrossRef32
Francesco Di Mario, Nicoletta Stefani, Nadia Dal Bò, Massimo Rugge, Alberto Pilotto, Giulia Martina Cavestro, Lucas Giovanni Cavallaro, Angelo Franzé, Gioacchino Leandro. (2005) Natural Course of Functional Dyspepsia After Helicobacter pyloriEradication: A Seven-Year Survey. Digestive Diseases and Sciences 50:12, 2286-2295
CrossRef33
Nicholas J. Talley, Nimish B. Vakil, Paul Moayyedi. (2005) American Gastroenterological Association Technical Review on the Evaluation of Dyspepsia. Gastroenterology 129:5, 1756-1780
CrossRef34
HIDEKAZU SUZUKI, TATSUHIRO MASAOKA, GEN SAKAI, HIROMASA ISHII, TOSHIFUMI HIBI. (2005) Improvement of gastrointestinal quality of life scores in cases of Helicobacter pylori-positive functional dyspepsia after successful eradication therapy. Journal of Gastroenterology and Hepatology 20:11, 1652-1660
CrossRef35
Nicholas J. Talley, Nimish Vakil, . (2005) Guidelines for the Management of Dyspepsia. The American Journal of Gastroenterology 100:10, 2324-2337
CrossRef36
Anna Garc??a-Alt??s, Rosa Rota, Merc?? Barenys, ??gueda Abad, Victor Moreno, Joan M.V. Pons, Josep M. Piqu??. (2005) Cost-effectiveness of a ???score and scope??? strategy for the management of dyspepsia. European Journal of Gastroenterology & Hepatology 17:7, 709-719
CrossRef37
Craig A. Friesen, Zhiyue Lin, Robert Garola, Linda Andre, Nancy Burchell, Anne Moore, Charles C. Roberts, Richard W. McCallum. (2005) Chronic Gastritis Is Not Associated with Gastric Dysrhythmia or Delayed Solid Emptying in Children with Dyspepsia. Digestive Diseases and Sciences 50:6, 1012-1018
CrossRef38
E. A. Ott, L. E. Mazzoleni, M. I. Edelweiss, G. B. Sander, A. C. Wortmann, A. L. Theil, G. Somm, A. Cartell, L. F. Rivero, D. M. Uchoa, C. F. Francesconi, J. C. Prolla. (2005) Helicobacter pylori eradication does not cause reflux oesophagitis in functional dyspeptic patients: a randomized, investigator-blinded, placebo-controlled trial. Alimentary Pharmacology and Therapeutics 21:10, 1231-1239
CrossRef39
Jan Tack, K J Lee. (2005) Pathophysiology and Treatment of Functional Dyspepsia. Journal of Clinical Gastroenterology 39:Supplement 3, S211-S216
CrossRef40
Riccardo Marmo, Gianluca Rotondano, Roberto Piscopo, Maria Antonia Bianco, Paola Russo, Paola Capobianco, Livio Cipolletta. (2005) Combination of Age and Sex Improves the Ability to Predict Upper Gastrointestinal Malignancy in Patients with Uncomplicated Dyspepsia: A Prospective Multicentre Database Study. The American Journal of Gastroenterology 100:4, 784-791
CrossRef41
FULL-YOUNG CHANG. (2005) Electrogastrography: Basic knowledge, recording, processing and its clinical applications. Journal of Gastroenterology and Hepatology 20:4, 502-516
CrossRef42
M.T. Cuddihy, G.R. Locke, D. Wahner-Roedler, R. Dierkhising, A.R. Zinsmeister, K Hall Long, N.J. Talley. (2005) Dyspepsia management in primary care: a management trial. International Journal of Clinical Practice 59:2, 194-201
CrossRef43
P Moayyedi, S Soo, J Deeks, B Delaney, A Harris, M Innes, R Oakes, S Wilson, A Roalfe, C Bennett, D Forman, Paul Moayyedi. 2005. Eradication of Helicobacter pylori for non-ulcer dyspepsia. .
CrossRef44
Sang In Lee. (2005) Functional Dyspepsia. Journal of the Korean Medical Association 48:1, 48
CrossRef45
Hidekazu Suzuki, Toshifumi Hibi. (2005) Novel effects other than antisecretory action and off-label use of proton pump inhibitors. Expert Opinion on Pharmacotherapy 6:1, 59-67
CrossRef46
K. Haruma. (2004) Review article: influence of Helicobacter pylori on gastro-oesophageal reflux disease in Japan. Alimentary Pharmacology and Therapeutics 20:s8, 40-44
CrossRef47
Jan Tack, Raf Bisschops, Giovanni Sarnelli. (2004) Pathophysiology and treatment of functional dyspepsia. Gastroenterology 127:4, 1239-1255
CrossRef48
Sefa G??liter, Ugur Kandilci. (2004) The Effect of Helicobacter pylori Eradication on Gastroesophageal Reflux Disease. Journal of Clinical Gastroenterology 38:9, 750-755
CrossRef49
Merja Ashorn, Tiina R??g??, Jorma Kokkonen, Tarja Ruuska, Hilpi Rautelin, Riitta Karikoski. (2004) Symptomatic Response to Helicobacter Pylori Eradication in Children With Recurrent Abdominal Pain:. Journal of Clinical Gastroenterology 38:8, 646-650
CrossRef50
Suzanne Timmons, Richard Liston, Kieran J. Moriarty. (2004) Functional Dyspepsia: Motor Abnormalities, Sensory Dysfunction, and Therapeutic Options. The American Journal of Gastroenterology 99:4, 739-749
CrossRef51
N. S. Abraham, P. Moayyedi, B. Daniels, S. J. O. Veldhuyzen Van Zanten. (2004) The methodological quality of trials affects estimates of treatment efficacy in functional (non-ulcer) dyspepsia. Alimentary Pharmacology and Therapeutics 19:6, 631-641
CrossRef52
Craig A. Friesen, Gregory L. Kearns, Linda Andre, Mark Neustrom, Charles C. Roberts, Susan M. Abdel-Rahman. (2004) Clinical Efficacy and Pharmacokinetics of Montelukast in Dyspeptic Children with Duodenal Eosinophilia. Journal of Pediatric Gastroenterology and Nutrition 38:3, 343-351
CrossRef53
W. D. Chey, P. Moayyedi. (2004) Uninvestigated dyspepsia and non-ulcer dyspepsia-the use of endoscopy and the roles of Helicobacter pylori eradication and antisecretory therapy. Alimentary Pharmacology and Therapeutics 19:s1, 1-8
CrossRef54
G. Treiber, M. Schwabe, S. Ammon, S. Walker, U. Klotz, P. Malfertheiner. (2004) Dyspeptic symptoms associated with Helicobacter pylori infection are influenced by strain and host specific factors. Alimentary Pharmacology and Therapeutics 19:2, 219-231
CrossRef55
Marjorie M. Walker. (2003) Biopsy assessment of drug efficacy in the gastrointestinal tract. British Journal of Clinical Pharmacology 56:5, 483-488
CrossRef56
Magnus Simren, Rita Vos, Jozef Janssens, Jan Tack. (2003) Unsuppressed postprandial phasic contractility in the proximal stomach in functional dyspepsia: relevance to symptoms. The American Journal of Gastroenterology 98:10, 2169-2175
CrossRef57
Wendy Hall, Martin Buckley, Paul Crotty, Colm A O’Morain. (2003) Gastric mucosal mast cells are increased in Helicobacter pylori-negative functional dyspepsia. Clinical Gastroenterology and Hepatology 1:5, 363-369
CrossRef58
Sander Zanten, Richard N. Fedorak, Jean Lambert, Lawrence Cohen, Anita Vanjaka. (2003) Absence of symptomatic benefit of lansoprazole, clarithromycin, and amoxicillin triple therapy in eradication of Helicobacter pylori positive, functional (nonulcer) dyspepsia. The American Journal of Gastroenterology 98:9, 1963-1969
CrossRef59
P. Malfertheiner, J. MOssner, W. Fischbach, P. Layer, A. Leodolter, M. Stolte, K. Demleitner, W. Fuchs. (2003) Helicobacter pylori eradication is beneficial in the treatment of functional dyspepsia. Alimentary Pharmacology and Therapeutics 18:6, 615-625
CrossRef60
T. Kamada, K. Haruma, J. Hata, H. Kusunoki, A. Sasaki, M. Ito, S. Tanaka, M. Yoshihara. (2003) The long-term effect of Helicobacter pylori eradication therapy on symptoms in dyspeptic patients with fundic atrophic gastritis. Alimentary Pharmacology and Therapeutics 18:2, 245-252
CrossRef61
YOUNG-WOON CHANG, SUN-KEE MIN, KYUNG-JIN KIM, YO-SEOB HAN, JOO-HEE LEE, SEOK-HO DONG, HYO-JONG KIM, BYUNG-HO KIM, JOUNG-IL LEE, RIN CHANG. (2003) Delta 13 C-urea breath test value is a useful indicator for Helicobacter pylori eradication in patients with functional dyspepsia. Journal of Gastroenterology and Hepatology 18:6, 726-731
CrossRef62
Magnus Simrén, Jan Tack. (2003) Functional dyspepsia: evaluation and treatment. Gastroenterology Clinics of North America 32:2, 577-599
CrossRef63
R. J.F. Laheij, L. G.M. van Rossum, A. L.M. Verbeek, J. B.M.J. Jansen. (2003) Helicobacter pylori Infection Treatment of Nonulcer Dyspepsia. Journal of Clinical Gastroenterology 36:4, 315-320
CrossRef64
Kenneth R. McQuaid. (2003) Eradication of Helicobacter pylori in Nonulcer Dyspepsia. Journal of Clinical Gastroenterology 36:4, 291-294
CrossRef65
H. H.-X. Xia, N. J. Talley, A. L. Blum, C. A. O'Morain, M. Stolte, E. Bolling-Sternevald, H. M. Mitchell. (2003) Clinical and pathological implications of IgG antibody responses toHelicobacter pyloriand its virulence factors in non-ulcer dyspepsia. Alimentary Pharmacology and Therapeutics 17:7, 935-943
CrossRef66
Karl M. Hoffmann, Andreas J. Eherer, Günter J. Krejs. (2003) Are dyspeptic symptoms linked to Helicobacter pylori? A prospective cohort study among medical students. Wiener Klinische Wochenschrift 115:5-6, 175-178
CrossRef67
A. Quadri, N. Vakil. (2003) Health-related anxiety and the effect of open-access endoscopy in US patients with dyspepsia. Alimentary Pharmacology and Therapeutics 17:6, 835-840
CrossRef68
F. Perri, V. Festa, E. Grossi, N. Garbagna, G. Leandro, A. Andriulli. (2003) Dyspepsia and Helicobacter pylori infection: a prospective multicentre observational study. Digestive and Liver Disease 35:3, 157-164
CrossRef69
N. Broutet, S. Tchamgoue, E. Pereira, H. Lamouliatte, R. Salamon, F. Megraud. (2003) Risk factors for failure of Helicobacter pylori therapy - results of an individual data analysis of 2751 patients. Alimentary Pharmacology and Therapeutics 17:1, 99-109
CrossRef70
Nimish Vakil. (2002) Nonulcer dyspepsia. Current Gastroenterology Reports 4:6, 455-458
CrossRef71
M. Hojo, H. Miwa, T. Ohkusa, R. Ohkura, A. Kurosawa, N. Sato. (2002) Alteration of histological gastritis after cure of Helicobacter pylori infection. Alimentary Pharmacology and Therapeutics 16:11, 1923-1932
CrossRef72
Craig A. Friesen, Linda Andre, Robert Garola, Charles Hodge, Charles Roberts. (2002) Activated Duodenal Mucosal Eosinophils in Children With Dyspepsia: A Pilot Transmission Electron Microscopic Study. Journal of Pediatric Gastroenterology and Nutrition 35:3, 329-333
CrossRef73
A. Shiotani, M. Iguchi, I. Inoue, H. Magari, K. Yanaoka, H. Tamai, S. Kitauchi, M. Ichinose. (2002) Association between gastric myoelectrical activity and intraluminal nitric oxide. Alimentary Pharmacology and Therapeutics 16:s2, 44-51
CrossRef74
Amnon Sonnenberg. (2002) What To Do About Helicobacter pylori? A Decision Analysis of its Implication on Public Health. Helicobacter 7:1, 60-66
CrossRef75
Kiichi Satoh. (2002) Indications forHelicobacter pylori eradication therapy and firstline therapy regimen in Japan: recommendation by the Japanese Society forHelicobacter Research. Journal of Gastroenterology 37:S13, 34-38
CrossRef76
F. Bazzoli, G. Bianchi Porro, G. Maconi, M. Molteni, P. Pozzato, R.M. Zagari. (2002) Treatment of Helicobacter pylori infection. indications and regimens: an update. Digestive and Liver Disease 34:1, 70-83
CrossRef77
A Vincze. (2001) One year follow-up of patients after successful helicobacter pylori eradication therapy. Journal of Physiology-Paris 95:1-6, 457-460
CrossRef78
D. Williams, P. O'Kelly, A. Kelly, J. Feely. (2001) Lack of symptom benefit following presumptive Helicobacter pylori eradication therapy in primary care. Alimentary Pharmacology and Therapeutics 15:11, 1769-1775
CrossRef79
Nimish Vakil. (2001) HELICOBACTER PYLORI AND THE RISK OF GASTRIC CANCER. Evidence-Based Gastroenterology 2:4, 145-146
CrossRef80
N. J. Talley, D. S. Riff, H. Schwartz, S. P. Marcuard. (2001) Double-blind placebo-controlled multicentre studies of rebamipide, a gastroprotective drug, in the treatment of functional dyspepsia with or without Helicobacter pylori infection. Alimentary Pharmacology and Therapeutics 15:10, 1603-1611
CrossRef81
J. Koskenpato, M. Farkkila, P. Sipponen. (2001) Helicobacter pylori eradication and standardized 3-month omeprazole therapy in functional dyspepsia. The American Journal of Gastroenterology 96:10, 2866-2872
CrossRef82
Fox, James G., , Wang, Timothy C., . (2001) Helicobacter pylori — Not a Good Bug after All. New England Journal of Medicine 345:11, 829-832
Full Text83
Masahiro Asaka, Kiichi Satoh, Kentaro Sugano, Toshiro Sugiyama, Shin-ichi Takahashi, Yoshihiro Fukuda, Hiroyoshi Ota, Kazushige Murakami, Ken Kimura, Takashi Shimoyama. (2001) Guidelines in the Management of Helicobacter pylori Infection in Japan. Helicobacter 6:3, 177-186
CrossRef84
J.-C Pechère. (2001) New perspectives on macrolide antibiotics. International Journal of Antimicrobial Agents 18, 93-97
CrossRef85
S. Bruley Des Varannes, J. F. Flejou, R. Colin, M. Zaim, A. Meunier, C. Bidaut-Mazel. (2001) There are some benefits for eradicating Helicobacter pylori in patients with non-ulcer dyspepsia. Alimentary Pharmacology and Therapeutics 15:8, 1177-1185
CrossRef86
Yvan Vandenplas. (2001) The role of Helicobacter pylori in paediatrics. Current Opinion in Infectious Diseases 14:3, 315-321
CrossRef87
R. Meier, A. Wettstein, J. Drewe, H. R. Geiser, . (2001) Fish oil (Eicosapen) is less effective than metronidazole, in combination with pantoprazole and clarithromycin, for Helicobacter pylori eradication. Alimentary Pharmacology and Therapeutics 15:6, 851-855
CrossRef88
J.R. Malagelada. (2001) The continuing dilemma of dyspepsia. Alimentary Pharmacology and Therapeutics 15:s1, 6-9
CrossRef89
T. Azuma, Y. Ito, H. Suto, M. Ohtani, M. Dojo, A. Muramatsu, M. Kuriyama, T. Kato. (2001) The effect of Helicobacter pylori eradication therapy on dyspepsia symptoms in industrial workers in Japan. Alimentary Pharmacology and Therapeutics 15:6, 805-811
CrossRef90
Benjamin D. Gold. (2001) New approaches to helicobacter pylori infection in children. Current Gastroenterology Reports 3:3, 235-247
CrossRef91
Pippa E. S. Bowie, Rosamond A. Cox, Andrew R. Davidson, Andrew Steel. (2001) Young dyspeptic patients: with a test-and-treat policy, are the benefits of decreased symptom severity and oesophago-gastro-duodenoscopy workload sustained?. European Journal of Gastroenterology & Hepatology 13:5, 541-545
CrossRef92
F. Cremonini, A. Gasbarrini, A. Armuzzi, G. Gasbarrini. (2001) Helicobacter pylori-related diseases. European Journal of Clinical Investigation 31:5, 431-437
CrossRef93
N. J. Talley, S. V. Van Zanten, L. R. Saez, G. Dukes, T. Perschy, M. Heath, C. Kleoudis, A. W. Mangel. (2001) A dose-ranging, placebo-controlled, randomized trial of alosetron in patients with functional dyspepsia. Alimentary Pharmacology and Therapeutics 15:4, 525-537
CrossRef94
Akira Kawamura, Kyoichi Adachi, Toshiharu Takashima, Mitsuyoshi Murao, Tomoko Katsube, Mika Yuki, Makoto Watanabe, Yoshikazu Kinoshita. (2001) Prevalence of functional dyspepsia and its relationship with Helicobacter pylori infection in a Japanese population. Journal of Gastroenterology and Hepatology 16:4, 384-388
CrossRef95
Nicholas J. Talley. (2001) Therapeutic Options in Nonulcer Dyspepsia. Journal of Clinical Gastroenterology 32:4, 286-293
CrossRef96
Arianna Gonelli, Sergio Boccia, Michela Boni, Alessandro Pozzoli, Caterina Rizzo, Patrizia Querzoli, Enzo Cassai, Dario Di Luca. (2001) Human herpesvirus 7 is latent in gastric mucosa. Journal of Medical Virology 63:4, 277-283
CrossRef97
Mark Li-cheng Wu, Klaus J. Lewin. (2001) Understanding helicobacter pylori. Human Pathology 32:3, 247-249
CrossRef98
Peter W. Groeneveld, Tracy A. Lieu, A. Mark Fendrick, Leo B. Hurley, Lynn M. Ackerson, Theodore R. Levin, James E. Allison. (2001) Quality of life measurement clarifies the cost-effectiveness of Helicobacter pylori eradication in peptic ulcer disease and uninvestigated dyspepsia1. The American Journal of Gastroenterology 96:2, 338-347
CrossRef99
Harry Hua-Xiang Xia, Benjamin Chun Yu Wong, Nicholas J Talley, Shiu Kum Lam. (2001) Helicobacter pylori infection - current treatment practice. Expert Opinion on Pharmacotherapy 2:2, 253-266
CrossRef100
J. M. Scheiman, R. R. Bandekar, M. E. Chernew, A. M. Fendrick. (2001) Helicobacter pylori screening for individuals requiring chronic NSAID therapy: a decision analysis. Alimentary Pharmacology and Therapeutics 15:1, 63-71
CrossRef101
Maxwell A. Asante. (2001) Optimal Management of Patients With Non-Ulcer Dyspepsia. Drugs & Aging 18:11, 819-826
CrossRef102
Anne M. Rentz, Carmelina Battista, Elyse Trudeau, Robert Jones, Patricia Robinson, Sheldon Sloan, Sonika Mathur, Lori Frank, Dennis A. Revicki. (2001) Symptom and Health-Related Quality-of-Life Measures for Use in Selected Gastrointestinal Disease Studies. PharmacoEconomics 19:4, 349-363
CrossRef103
Santos Santolaria, Ramon Guirao, Julio Ducóns, Jesus García Cabezudo, Miguel Montoro, Fernando Gomollon. (2001) Dual Therapy with Ranitidine Bismuth Citrate for Helicobacter pylori Eradication. Journal of Clinical Gastroenterology 32:1, 90-91
CrossRef104
K.E.L. McColl. (2000) Helicobacter pylori and dyspepsia. Pro and against. Digestive and Liver Disease 32, 199-201
CrossRef105
V. De Francesco, A. Zullo, V. Rinaldi, C. Hassan, P. Ballanti, S. Winn, F. Diana, S. Morini, A.F. Attili. (2000) Relationship between antral lymphocyte density and basal gastrin levels in patients with Helicobacter pylori infection. Digestive and Liver Disease 32:8, 676-681
CrossRef106
Johann Hammer, Nicholas J. Talley. (2000) Nonulcer dyspepsia. Current Opinion in Gastroenterology 16:6, 503-507
CrossRef107
Joshua J. Ofman. (2000) What have we learned from recent dyspepsia trials?. Current Gastroenterology Reports 2:6, 471-477
CrossRef108
V. Stanghellini, C. Tosetti, G. Barbara, R. De Giorgio, B. Salvioli, R. Corinaldesi. (2000) The continuing dilemma of dyspepsia. Alimentary Pharmacology and Therapeutics 14:s3, 23-30
CrossRef109
P. Malfertheiner, C. Gerards. (2000) Helicobacter pylori infection and gastro-oesophageal reflux disease: coincidence or association?. Best Practice & Research Clinical Gastroenterology 14:5, 731-741
CrossRef110
Gnj Tytgat. (2000) Helicobacter pylori: Past, present and future. Journal of Gastroenterology and Hepatology 15:s3, G30-G33
CrossRef111
J Torres. (2000) A Comprehensive Review of the Natural History of Helicobacter pylori Infection in Children. Archives of Medical Research 31:5, 431-469
CrossRef112
Bernard Coulie, Michael Camilleri. (2000) New therapies for functional bowel diseases. Current Gastroenterology Reports 2:5, 355-363
CrossRef113
Mark W. Whitehead, Rosemary H. Phillips, Christine E. Sieniawska, H. Trevor Delves, Paul T. Seed, Richard P.H. Thompson, Jonathan J. Powell. (2000) Double-Blind Comparison of Absorbable Colloidal Bismuth Subcitrate and Nonabsorbable Bismuth Subnitrate in the Eradication of Helicobacter pylori and the Relief of Nonulcer Dyspepsia. Helicobacter 5:3, 169-175
CrossRef114
E. Hentschel. (2000) Therapie der Helicobacter pylori-Infektion*. Acta Medica Austriaca 27:4, 104-108
CrossRef115
Nimish Vakil. (2000) Heliobacter pylori and non-ulcer dyspepsia. Current Treatment Options in Gastroenterology 3:4, 341-345
CrossRef116
Fernando Mundo-Gallardo, , León Mezerville-Cantillo, Herbert Burgos-Quiroz, Edgar Izquierdo, Jorge Chang-Mayorga, Luis Azteguieta, Luis F. Passarrelli-Sandhoff. (2000) Latin American open-label study with rabeprazole in patients with functional dyspepsia. Advances in Therapy 17:4, 190-194
CrossRef117
A Gasbarrini, M Gabrielli, G Fiore, M Candelli, F Bartolozzi, A De Luca, F Cremonini, F Franceschi, C Di Campli, A Armuzzi, V Ojetti, M Serricchio, R Pola, G Gasbarrini, M Giacovazzo, P Pola. (2000) Association between Helicobacter pylori cytotoxic type I CagA-positive strains and migraine with aura. Cephalalgia 20:6, 561-565
CrossRef118
Jerry M. Zuckerman. (2000) THE NEWER MACROLIDES: AZITHROMYCIN AND CLARITHROMYCIN. Infectious Disease Clinics of North America 14:2, 449-462
CrossRef119
Javier P. Gisbert, Jose Maria Pajares. (2000) Helicobacter pylori"Test-and-Scope" Strategy for Dyspeptic Patients. Helicobacter 5:2, 57-68
CrossRef120
Paul Moayyedi, Richard Feltbower, Julia Brown, Su Mason, James Mason, Jackie Nathan, ID Gerald Richards, Anthony C Dowell, Anthony TR Axon. (2000) Effect of population screening and treatment for Helicobacter pylori on dyspepsia and quality of life in the community: a randomised controlled trial. The Lancet 355:9216, 1665-1669
CrossRef121
Robert Janknegt, Leopold G.J.B. Engels. (2000) Formulary Management of Eradication Therapies for Helicobacter pylori. Disease Management and Health Outcomes 7:5, 251-266
CrossRef122
Jeffrey S. Hyams, Patricia Davis, Francisco A. Sylvester, Donna K. Zeiter, Christopher J. Justinich, Trudy Lerer. (2000) Dyspepsia in Children and Adolescents: A Prospective Study. Journal of Pediatric Gastroenterology and Nutrition 30:4, 413-418
CrossRef123
Hession, Malagelada. (2000) Review article: the initial management of uninvestigated dyspepsia in younger patients-the value of symptom-guided strategies should be reconsidered. Alimentary Pharmacology and Therapeutics 14:4, 379-388
CrossRef124
John Danesh, Roy E Pounder. (2000) Eradication of Helicobacter pylori and non-ulcer dyspepsia. The Lancet 355:9206, 766-767
CrossRef125
Hiroto Miwa, Nobuhiro Sato. (2000) Functional dyspepsia and Helicobacter pylori infection: A recent consensus up to 1999. Journal of Gastroenterology and Hepatology 15:s1, 60-65
CrossRef126
(2000) Absence of Benefit of Eradicating Helicobacter pylori in Patients with Nonulcer Dyspepsia. New England Journal of Medicine 342:8, 589-590
Full Text127
Christine A. Wanke. (2000) The association of Helicobacter pylori infection with nonulcer dyspepsia. Current Infectious Disease Reports 2:1, 53-54
CrossRef128
Nimish Vakil, Mae F. Go. (2000) Treatment of Helicobacter pylori infection. Current Opinion in Gastroenterology 16:1, 32-39
CrossRef
- Letters
