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Best Pract Res Clin Gastroenterol. 2019 Jun - Aug;40-41:101637. doi: 10.1016/j.bpg.2019.101637. Epub 2019 Jul 22.

Helicobacter pylori eradication in dyspepsia: New evidence for symptomatic benefit.

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Department of Medicine II, University Hospital, LMU Munich, Germany.
Department of Medicine II, University Hospital, LMU Munich, Germany; Department of Gastroenterology, Hepatology and Infectious Diseases, University Hospital Magdeburg, Germany. Electronic address:


A causal relationship between Helicobacter pylori (H. pylori) infection and functional dyspepsia (FD) is well established in a subset of infected patients. In the Kyoto and Maastricht/Florence consensus reports H. pylori-associated dyspepsia is defined as an independent entity distinct from FD. H. pylori eradication is therefore the most cost-effective approach for infected patients with dyspeptic symptoms and superior to other medical therapies, such as Proton Pump Inhibitors. The therapeutic gain of H.pylori eradication for symptom relief compared to other therapeutic options is significant with the number needed to benefit of 12. Furthermore H.pylori cures chronic gastritis except in severe cases of atrophic gastritis and may prevent severe complications attributable to the infection. Several pathophysiological mechanisms are suggested for the generation of symptoms and are related to the distinct topographic expression and degree of gastric inflammation as well as changes of gastric acid secretion, gastrointestinal motility and visceral hypersensitivity.


Epigastric pain syndrome; Eradication; Functional dyspepsia; Helicobacter pylori infection; Postprandial distress syndrome

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