Treating non-ulcer dyspepsia and H pylori

摘要

Helicobacter pylori is the main cause of duodenal and gastric ulcers. The organism has also been linked to gastric cancer. Most researchers believe that there is a relation, although an imperfect one, between non-ulcer dyspepsia and infection with H pylori. The pathophysiological mechanisms by which the infection may cause dyspepsia are unclear, but may include changes in acid secretion, abnormal motility, or altered visceral perception. The prevalence of H pylori is higher in patients with non-ulcer dyspepsia than in healthy controls. A pivotal question is whether curing the infection leads to a sustained improvement in symptoms in patients with non-ulcer dyspepsia. The controversy surrounding mis issue is addressed by the meta-analysis by Moayyedi et al in this issue of the journal (p 659).