Journal of Neurogastroenterology and Motility

The Korean Society of Neurogastroenterology and Motility (대한소화기 기능성질환 운동학회)
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Effect of Helicobacter pylori Eradication on Functional Dyspepsia

  • Kim, Sung Eun (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Park, Young Soo (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Nayoung (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Min Soo (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Jo, Hyun Jin (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Shin, Cheol Min (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Sang Hyub (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Hwang, Jin-Hyeok (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Jin-Wook (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Jeong, Sook-Hyang (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Dong Ho (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Jung, Hyun Chae (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine)
  • Received : 2012.11.21
  • Accepted : 2012.12.14
  • Published : 2013.04.30
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Abstract

Background/Aims This study evaluated the effect of Helicobacter pylori eradication on functional dyspepsia (FD), and the relationship between the changes of histological gastritis and FD symptom responses. Methods A total of 213 FD patients diagnosed by Rome III criteria were consecutively enrolled. H. pylori tests and gastritis grade by the Sydney system were performed before and 1 year after the proton pump based-eradication therapy for 7 days. Serum levels of pepsinogen, and genetic polymorphisms IL-6, IL-8 and IL-10 were investigated. Results Total of 91 patients completed the 1 year follow-up. When the response rate of dyspepsia was compared at 1 year between the non-eradicated group (n = 24) and eradicated group (n = 67), each group showed complete response of 62.5% and 62.7%; satisfactory response (${\geq}50%$) of 0.0% and 19.4%; partial response (< 50%) of 12.5% and 11.9%; and refractory response of 25.0% and 6.0%, respectively (P = 0.015). In addition, the responder group (complete + satisfactory response) at 1 year showed improvement of activity and chronic inflammation in both the antrum and corpus (all P < 0.001). Multivariate analysis showed that H. pylori eradication (OR, 5.81; 95% CI, 1.07-31.59) and symptom improvement at 3 month (OR, 28.90; 95% CI, 5.29-157.82) were associated with the improvement of dyspepsia at 1 year. Among the successfully eradicated FD patients (n = 67), male (P = 0.013) and higher initial BMI (P = 0.016) were associated with the improvement of dyspepsia at 1 year. Conclusions H. pylori eradication improved FD symptoms, as well as gastritis at 1 year, suggesting that inflammation mediates FD.

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