Should anti-Helicobacter therapy be different in patients with dyspepsia compared with patients with peptic ulcer diathesis?

Abstract:

:Physicians should try to reach an optimal cure rate with initial anti-Helicobacter therapy. Helicobacter pylori infection in patients with peptic ulcer disease (PUD) is more likely to be cured then in patients with 'functional' dyspepsia (FD). Differences in cure rates of 5-15% are usually reported, which is considered to be clinically relevant. Different strains (virulent v. non-virulent) in PUD and FD may induce different alterations in the gastric mucosa, and thereby either facilitate or impair antimicrobial efficacy. A study in this journal showed that triple therapy with ranitidine bismuth citrate (RBC) was superior to triple therapy with a proton pump inhibitor (PPI), but only in the more-difficult-to-cure FD patients. Clinicians should be aware that most published treatment studies have included only PUD patients. This means that in clinical practice the cure rates obtained in patients with FD or even uninvestigated dyspepsia will usually be lower then those reported in the literature. One way to deal with this is to consider prolonging the duration of an initial anti-Helicobacter therapy from 7 to 10 or 14 days in patients without ulcers.

authors

de Boer WA,Tytgat GN

doi

10.1097/00042737-200111000-00002

subject

Has Abstract

pub_date

2001-11-01 00:00:00

pages

1281-4

issue

11

eissn

0954-691X

issn

1473-5687

journal_volume

13

pub_type

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