Prevalence of Helicobacter pylori and the Interest of Its Eradication during the Functional Dyspepsia

Functional dyspepsia constitutes by its impact in quality of life and socio-economic impact areal public health problem (40% of the adult population in the Western world). The prevalence of infection with Helicobacter pylori (HP) in patients with functional dyspepsia is about 30% - 70%. The aim of our study is to observe the improvement of functional dyspepsia (FD) after Helicobacter pylori (HP) eradication. Methods: This is a prospective study over a period of 68 months (May 2009 - January 2015). We included all patients aged over 15 years, with functional dyspepsia defined by the Rome III criteria. The diagnosis of HP was made by histology and/or PCR. Patients infected with HP were treated in single-blind: standard triple therapy for 7 days or sequential treatment for 10 days. HP eradication control was made after: 3 months, 6 months and one year of treatment. Results: During the study period, 1190 patients were included of which 250 patients (21%) were in functional dyspepsia according to the Rome III criteria. The average age in patients with functional dyspepsia was 49 years [16 - 80], sex ratio M/F was 0.58 (N = 92/158). 60% of patients were older than 45 years (N = 150). Chronic smoking was found in 20% of patients (N = 50). One hundred and seventy five patients (70%) had HP infection (N = 175). One hundred and sixty five patients received the treatment of Helicobacter pylori (94.28%), 10 patients were lost to follow (5.71%). The eradication of HP was obtained in 98.41% with sequential treatment versus 88.73% with standard triple therapy (p = 0.026). All patients were reviewed at 3 months and 6 months after treatment, 86% were reviewed at 12 months (N = 143). Dyspeptic symptoms was disappeared in 43% of our patients (N = 71) partial disappearance of symptoms in 34.5% of cases (N = 57) persistence of symptoms in 22.42% of cases (N = 37). Conclusion: In our study the prevalence of Helicobacter pylori infection in patients with functional dyspepsia is high: 70%. Sequential therapy is better than the standard triple therapy in the eradication of HP in patients with nonulcer dyspepsia, which improves their symptoms in more than 50% of cases.