ABSTRACT
Purpose: to assess whether Helicobacter pylori [H. pylori] eradication therapy benefits patients with functional dyspepsia [FD]
Methods: randomized controlled trials [RCTs] examining the efficacy and safety of H. pylori eradication therapy for patients with functional dyspepsia published in English [till November 2016] were recognized by searching PubMed, EMBASE, and The Cochrane Library. Pooled estimates were measured using the fixed or random effect model. Overall effect was expressed as a pooled risk ratio [RR] or a standard mean difference [SMD]. All data were analyzed with Review Manager 5.3 and Stata 12.0
Results: this analysis involved 15 RCTs with a total of 3567 patients with FD. These studies were used to assess the benefits of H. pylori eradication therapy for symptom improvement; the pooled RR was 1.26 [95%CI: 1.10-1.40, P < 0.0001]. H. pylori eradication therapy demonstrated symptom improvement during long-term follow-up at >/= 1 year [RR = 1.27; 95%CI: 1.13-1.41, P < 0.0001] but not during short-term follow-up at < 1 year [RR = 1.26; 95%CI: 0.83-1.92, P = 0.27]. Four studies showed no benefit of H. pylori eradication therapy on quality of life with an SMD of -0.01 [95%CI: -0.09 to 0.07, P = 0.74]. Four studies demonstrated that H. pylori eradication therapy reduced the development of peptic ulcer disease compared to no eradication therapy [RR = 0.34; 95%CI: 0.17-0.67, P = 0.002]. Three studies showed that H. pylori eradication therapy increased the likelihood of treatment-related side effects compared to no eradication therapy [RR = 1.87; 95%CI: 1.08-3.47, P = 0.02]. Ten studies demonstrated that patients who received H. pylori eradication therapy were more likely to obtain histologic resolution of chronic gastritis compared to those who did not receive eradication therapy [RR = 7.05; 95%CI: 3.59-13.74, P < 0.00001]
Conclusion: the decision to eradicate H. pylori in patients with functional dyspepsia requires individual assessment