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Therapeutics
Helicobacter pylori eradication improved dyspepsia symptoms

https://doi.org/10.1136/ebm.8.1.21

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    (2002) BMJ 324, 1012; Chiba N, Veldhuyzen van Zanten SJ, Sinclair P, et al.. Treating Helicobacter pylori infection in primary care patients with uninvestigated dyspepsia: the Canadian adult dyspepsia empiric treatment—Helicobacter pylori positive (CADET-Hp) randomised controlled trial.. ;. :. –6..
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 QUESTION: In patients with dyspepsia and a positive test result for Helicobacter pylori, is an H pylori eradication strategy more effective than placebo for improving dyspepsia symptoms?

    Design

    Randomised {allocation concealed*}†, blinded (clinicians, patients, data collectors, outcome assessors, {data analysts, and manuscript writers}†),* placebo controlled trial with 1 year of follow up.

    Setting

    36 family practices in Canada.

    Patients

    294 patients (mean age 49 y, 50% men) who were ≥18 years of age and had uninvestigated symptoms of dyspepsia for ≥3 months. Dyspepsia was defined as a complex of epigastric pain including heartburn, acid regurgitation, excessive burping or belching, increased abdominal bloating, nausea, abnormal or slow digestion, or early satiety. All patients had to have positive test results for H pylori on the Helisal rapid blood test and the 13C-urea breath test. Exclusion criteria included gastrooesophageal reflux disease, upper gastrointestinal investigation in the previous 6 months or ≥2 times in the past 10 years, eradication therapy for H pylori in the past 6 months, previous gastric surgery, ulcer disease or endoscopic oesophagitis, and irritable bowel syndrome. Follow up was 87%.

    Intervention

    Patients were allocated to omeprazole, …

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    Footnotes

    • Source of funding: Astra-Zeneca Canada Inc.

    • For correspondence: Dr N Chiba, Surrey GI Clinic/Research, Guelph, Ontario, Canada. chiban{at}on.aibn.com

    • Abstract and commentary also published in ACP Journal Club

    • ↵* See glossary.

    • ↵† Information provided by author.