[Functional dyspepsia: approaches to Helicobacter pylori eradication therapy]

At the present, Helicobacter-associated gastritis is not considered to be an important cause of dyspeptic symptoms. Therefore, patients with dyspeptic symptoms and proven Helicobacter-gastritis are diagnosed as having functional dyspepsia, provided that Helicobacter-associated lesions like ulcers or malignancies are absent. It is controversial whether or not to treat a patient with functional dyspepsia with Helicobacter gastritis. Conclusive controlled clinical trials are lacking. If it is assumed in a given patient, that Helicobacter could be responsible for the complaints (an assumption which can never be proven and only suspected when the patient remains asymptomatic during longterm follow-up after cure of the infection) and if the patient has not responded to a standard treatment (antisecretory or prokinetic agents), we recommend Helicobacter therapy. Presently, in spring 1995, the following treatment is, in our view, the best choice during seven (to ten) days: The patient takes 20 mg omeprazol in the morning, 250 mg clarithromycin in the morning and in the evening and 500 mg metronidazole in the morning and in the evening.