Treatment of Helicobacter pylori in nonulcer dyspepsia: Should we or shouldn’t we?

ABSTRACT

Two recent trials of treatment to eradicate Helicobacter pylori in infected patients with nonulcer dyspepsia seemingly came to opposite conclusions: one found such treatment to be beneficial but the other did not. My interpretation: If a patient has unexplained dyspepsia and no abnormal findings on endoscopy, blood chemistry, or the blood count, it is reasonable to test for H pylori and to give antibiotics if he or she tests positive. However, in no more than approximately one fourth of such patients will the problem respond to therapy. Furthermore, one should never give anti-H pylori treatment without first obtaining proof of infection.