Efficacy of Helicobacter pylori eradication therapy on functional dyspepsia: a meta-analysis of randomized controlled studies with 12-month follow-up.

BACKGROUND: Whether patients with functional dyspepsia (FD) should receive Helicobacter pylori eradication therapy remains controversial.

AIMS: This meta-analysis was to evaluate the long-term effects of H. pylori eradication on dyspeptic symptoms of patients with FD, by selecting the most recent well-designed randomized controlled trials.

METHODS: English-language articles in the medical literature containing information on the long-term (≥ 12 mo) effects of H. pylori eradication on dyspeptic symptoms in patients with FD were identified by searching the Medline, PubMed, and EMBASE databases. The MeSH and/or keywords included Helicobacter pylori OR H. pylori OR HP; functional dyspepsia OR non-ulcer dyspepsia; eradication OR cure or treatment; and improvement OR resolution. The Review Manager 4.2.2 was used for the meta-analysis.

RESULTS: Fourteen randomized controlled studies were included in the meta-analysis. Improvements of dyspepsia symptoms in patients of eradication group were significantly better than in patients of the control group [odds ratio (OR), 1.38; 95% confidence interval (CI), 1.18-1.62] (Z=4.00, P<0.0001) at the end of the follow-up period with low heterogeneity (I=51.8%, P=0.01). In a subgroup analysis on geographical regions, improvements of dyspepsia symptoms in patients of eradication group were all significantly better than in patients of control group in the European (OR, 1.49; 95% CI, 1.10-2.02), Asian (OR, 1.54; 95% CI, 1.07-2.21), and American populations (OR, 1.43; 95% CI, 1.12-1.83).

CONCLUSIONS: H. pylori eradication therapy is associated with improvement of dyspeptic symptoms in patients with FD, which is consistently demonstrated in the Asian, European, and American populations.