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Gut. 1998 May;42(5):618-22.

Assessment of symptomatic response as predictor of Helicobacter pylori status following eradication therapy in patients with ulcer.

Author information

1
University Department of Medicine and Therapeutics, Western Infirmary, Glasgow, UK.

Abstract

BACKGROUND:

Helicobacter pylori eradication therapy is routinely used for treating patients with peptic ulcer disease.

AIMS:

To assess the value of symptomatic response to H pylori eradication therapy as a marker of post-treatment H pylori status.

PATIENTS AND METHODS:

One hundred and nine dyspeptic patients with active duodenal or gastric ulceration association with H pylori infection had their symptoms measured by a validated questionnaire before and three months following H pylori eradication therapy. The symptomatic response was compared with post-treatment H pylori status as determined by the 14C urea breath test.

RESULTS:

An eradication rate of 84% was achieved. Of the 92 patients eradicated of H pylori, 47% experienced complete or near complete resolution of dyspepsia. Of the 17 patients in whom the infection was not eradicated, only one (6%) experienced resolution of dyspepsia. Resolution of dyspepsia was therefore a powerful predictor of eradication of H pylori with a predictive value of 98%. In contrast, persistence of dyspepsia was a weak predictor of persisting infection with a predictive value of only 25%. Excluding patients with endoscopic evidence of coexisting oesophagitis and/or retrosternal discomfort or reflux at initial presentation did not increase the predictive value of persisting dyspepsia for persisting infection.

CONCLUSIONS:

Complete resolution of dyspeptic symptoms is a powerful predictor of eradication of H pylori infection in ulcer patients. Persistence of symptoms is a weak predictor of persisting infection and patients with persisting dyspepsia must have their H pylori status rechecked to guide future management.

PMID:
9659153
PMCID:
PMC1727091
[Indexed for MEDLINE]
Free PMC Article

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