Helicobacter pylori eradication in functional dyspepsia: new evidence for symptomatic benefit

Several large studies investigating the benefit of eradicating Helicobacter pylori in patients with functional dyspepsia have reported varying results, and therefore questions about the clinical management of H. pylori infection remain. The ELAN study, a recent large multicentre, randomized study, compared eradication of H. pylori (with lansoprazole and antibiotics) with acid-suppressant treatment alone (lansoprazole) in H. pylori-associated functional dyspepsia. Investigators found that eradication led to improvement of dyspeptic symptoms. Although the symptomatic benefit was limited to a small subset of patients (approximately 9%) with H. pylori-positive functional dyspepsia, cure of chronic gastritis can be offered to the majority of patients (approximately 80%) and thus, in addition to the elimination of symptoms in some, the key risk factor for gastroduodenal pathology is eliminated. This study provides support for the recommendations of Maastricht 2, which found that H. pylori eradication is an appropriate therapeutic option for functional dyspepsia.