Background/Aim:Helicobacter pylori (HP) eradication therapy was first recommended as pharmacotherapy for functional dyspepsia (FD). However, the mechanism and effect of eradication on FD symptom improvement have not been fully investigated. This study aimed to investigate the pathology of patients with HP-associated FD, and predictive factors for HP-associated FD. Methods: Ninety-seven patients with chronic gastritis caused by HP infection were divided into the group with FD symptoms and the group ­without FD symptoms. Patient backgrounds, QOL, gastric mucosal atrophy severity, and serum pepsinogen (PG) value were compared between the 2 groups. Twelve months after eradication, those factors were evaluated between HP-associated FD and HP-non-associated FD, and predictive factors of HP-associated FD were analyzed. Results: The FD-positive group existed in 45 (46.3%) out of 97 patients. Twelve months after eradication, there were 34 patients (75.6%) in the HP-associated FD. The mean PG I value in the HP-associated FD was significantly lower than that in the HP-non-associated FD, while the PG II values in the HP-associated FD tended to be lower than those in the HP-non-associated FD. QOL in the HP-associated FD significantly improved after HP eradication. On multivariate logistic regression analysis, it was found that PG II value was a significant predictive factor for FD symptom improvement in the HP-associated FD. Conclusion: HP eradication is an effective initial therapy for FD. PG II value is considered a predictive factor for FD symptom improvement through HP eradication.

1.
Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, Stanghellini V: Functional gastroduodenal disorders. Gastroenterology 2006; 130: 1466–1479.
2.
Stanghellini V, Tosetti C, Paternico A, Barbara G, Morselli-Labate AM, Monetti N, Marengo M, Corinaldesi R: Risk indicators of delayed gastric emptying of solids in patients with functional dyspepsia. Gastroenterology 1996; 110: 1036–1042.
3.
Mori H, Suzuki H, Matsuzaki J, Taniguchi K, Shimizu T, Yamane T, Masaoka T, Kanai T: Gender difference of gastric emptying in healthy volunteers and patients with functional dyspepsia. Digestion 2017; 95: 72–78.
4.
Moayyedi P, Delaney BC, Vakil N, Forman D, Talley NJ: The efficacy of proton pump inhibitors in nonulcer dyspepsia: a systematic review and economic analysis. Gastroenterology 2004; 127: 1329–1337.
5.
Moayyedi P, Soo S, Deeks J, Forman D, Mason J, Innes M, Delaney B: Systematic review and economic evaluation of helicobacter pylori eradication treatment for non-ulcer dyspepsia. Dyspepsia review group. BMJ 2000; 321: 659–664.
6.
Hammer J, Fuhrer M, Pipal L, Matiasek J: Hypersensitivity for capsaicin in patients with functional dyspepsia. Neurogastroenterol Motil 2008; 20: 125–133.
7.
Hata T, Kato M, Kudo T, Nishida M, Nishida U, Imai A, Yoshida T, Hirota J, Kamada G, Ono S, Nakagawa M, Nakagawa S, Shimizu Y, Takeda H, Asaka M: Comparison of gastric relaxation and sensory functions between functional dyspepsia and healthy subjects using novel drinking-ultrasonography test. Digestion 2013; 87: 34–39.
8.
Tack J, Piessevaux H, Coulie B, Caenepeel P, Janssens J: Role of impaired gastric accommodation to a meal in functional dyspepsia. Gastroenterology 1998; 115: 1346–1352.
9.
Lee KJ, Vos R, Janssens J, Tack J: Influence of duodenal acidification on the sensorimotor function of the proximal stomach in humans. Am J Physiol Gastrointest Liver Physiol 2004; 286:G278–G284.
10.
Aro P, Talley NJ, Ronkainen J, Storskrubb T, Vieth M, Johansson SE, Bolling-Sternevald E, Agreus L: Anxiety is associated with uninvestigated and functional dyspepsia (rome iii criteria) in a Swedish population-based study. Gastroenterology 2009; 137: 94–100.
11.
Sugano K, Tack J, Kuipers EJ, Graham DY, El-Omar EM, Miura S, Haruma K, Asaka M, Uemura N, Malfertheiner P: Kyoto global consensus report on helicobacter pylori gastritis. Gut 2015; 64: 1353–1367.
12.
Yamada S, Tomatsuri N, Kawakami T, Nakatsugawa Y, Nishimura T, Fujii H, Sato H, Okuyama Y, Kimura H, Yoshida N: Helicobacter pylori eradication therapy ameliorates latent digestive symptoms in chronic atrophic gastritis. Digestion 2018; 97: 333–339.
13.
Moayyedi P, Deeks J, Talley NJ, Delaney B, Forman D: An update of the cochrane systematic review of helicobacter pylori eradication therapy in nonulcer dyspepsia: resolving the discrepancy between systematic reviews. Am J Gastroenterol 2003; 98: 2621–2626.
14.
Jin X, Li YM: Systematic review and meta-analysis from chinese literature: The association between helicobacter pylori eradication and improvement of functional dyspepsia. Helicobacter 2007; 12: 541–546.
15.
Zhao B, Zhao J, Cheng WF, Shi WJ, Liu W, Pan XL, Zhang GX: Efficacy of helicobacter pylori eradication therapy on functional dyspepsia: a meta-analysis of randomized controlled studies with 12-month follow-up. J Clin Gastroenterol 2014; 48: 241–247.
16.
Suzuki H, Nishizawa T, Hibi T: Can helicobacter pylori-associated dyspepsia be categorized as functional dyspepsia? J Gastroenterol Hepatol 2011; 26(suppl 3): 42–45.
17.
Suzuki H, Matsuzaki J, Hibi T: What is the difference between helicobacter pylori-associated dyspepsia and functional dyspepsia? J Neurogastroenterol Motil 2011; 17: 124–130.
18.
Suzuki H, Mori H: Helicobacter pylori: Helicobacter pylori gastritis – a novel distinct disease entity. Nat Rev Gastroenterol Hepatol 2015; 12: 556–557.
19.
Stanghellini V, Chan FK, Hasler WL, Malagelada JR, Suzuki H, Tack J, Talley NJ: Gastroduodenal disorders. Gastroenterology 2016; 150: 1380–1392.
20.
Lefante JJ Jr, Harmon GN, Ashby KM, Barnard D, Webber LS: Use of the sf-8 to assess health-related quality of life for a chronically ill, low-income population participating in the central louisiana medication access program (CMAP). Qual Life Res 2005; 14: 665–673.
21.
Arai H, Ishibashi S, Bujo H, Hayashi T, Yokoyama S, Oikawa S, Kobayashi J, Shirai K, Ota T, Yamashita S, Gotoda T, Harada-Shiba M, Sone H, Eto M, Suzuki H, Yamada N: Management of type IIB dyslipidemia. J Atheroscler Thromb 2012; 19: 105–114.
22.
Revicki DA, Wood M, Wiklund I, Crawley J: Reliability and validity of the gastrointestinal symptom rating scale in patients with gastroesophageal reflux disease. Qual Life Res 1998; 7: 75–83.
23.
Abe M, Ito N, Masatani T, Nakagawa K, Yamaoka S, Kanamaru Y, Suzuki H, Shibano K, Arashi Y, Sugiyama M: Whole genome characterization of new bovine rotavirus g21p[29] and g24p[33] strains provides evidence for interspecies transmission. J Gen Virol 2011; 92: 952–960.
24.
Azuma T, Ito Y, Suto H, Ohtani M, Dojo M, Muramatsu A, Kuriyama M, Kato T: The effect of helicobacter pylori eradication therapy on dyspepsia symptoms in industrial workers in japan. Aliment Pharmacol Ther 2001; 15: 805–811.
25.
Kamada T, Haruma K, Hata J, Kusunoki H, Sasaki A, Ito M, Tanaka S, Yoshihara M: The long-term effect of helicobacter pylori eradication therapy on symptoms in dyspeptic patients with fundic atrophic gastritis. Aliment Pharmacol Ther 2003; 18: 245–252.
26.
Miwa H, Hirai S, Nagahara A, Murai T, Nishira T, Kikuchi S, Takei Y, Watanabe S, Sato N: Cure of helicobacter pylori infection does not improve symptoms in non-ulcer dyspepsia patients-a double-blind placebo-controlled study. Aliment Pharmacol Ther 2000; 14: 317–324.
27.
Olafsdottir LB, Gudjonsson H, Jonsdottir HH, Thjodleifsson B: Natural history of functional dyspepsia: a 10-year population-based study. Digestion 2010; 81: 53–61.
28.
Stanghellini V: Three-month prevalence rates of gastrointestinal symptoms and the influence of demographic factors: results from the domestic/international gastroenterology surveillance study (DIGEST). Scand J Gastroenterol Suppl 1999; 231: 20–28.
29.
Haag S, Senf W, Hauser W, Tagay S, Grandt D, Heuft G, Gerken G, Talley NJ, Holtmann G: Impairment of health-related quality of life in functional dyspepsia and chronic liver disease: the influence of depression and anxiety. Aliment Pharmacol Ther 2008; 27: 561–571.
30.
Drossman DA, Li Z, Andruzzi E, Temple RD, Talley NJ, Thompson WG, Whitehead WE, Janssens J, Funch-Jensen P, Corazziari E, et al: U.S. Householder survey of functional gastrointestinal disorders. Prevalence, sociodemography, and health impact. Dig Dis Sci 1993; 38: 1569–1580.
31.
Koloski NA, Talley NJ, Boyce PM: Epidemiology and health care seeking in the functional gi disorders: a population-based study. Am J Gastroenterol 2002; 97: 2290–2299.
32.
Miki K, Fujishiro M, Kodashima S, Yahagi N: Long-term results of gastric cancer screening using the serum pepsinogen test method among an asymptomatic middle-aged Japanese population. Dig Endosc 2009; 21: 78–81.
33.
Yoshihara M, Hiyama T, Yoshida S, Ito M, Tanaka S, Watanabe Y, Haruma K: Reduction in gastric cancer mortality by screening based on serum pepsinogen concentration: a case-control study. Scand J Gastroenterol 2007; 42: 760–764.
34.
Miki K, Urita Y: Using serum pepsinogens wisely in a clinical practice. J Dig Dis 2007; 8: 8–14.
35.
Oishi Y, Kiyohara Y, Kubo M, Tanaka K, Tanizaki Y, Ninomiya T, Doi Y, Shikata K, Yonemoto K, Shirota T, Matsumoto T, Iida M: The serum pepsinogen test as a predictor of gastric cancer: the hisayama study. Am J Epidemiol 2006; 163: 629–637.
36.
Dinis-Ribeiro M, Yamaki G, Miki K, Costa-Pereira A, Matsukawa M, Kurihara M: Meta-analysis on the validity of pepsinogen test for gastric carcinoma, dysplasia or chronic atrophic gastritis screening. J Med Screen 2004; 11: 141–147.
37.
Urita Y, Hike K, Torii N, Kikuchi Y, Kanda E, Sasajima M, Miki K: Serum pepsinogens as a predicator of the topography of intestinal metaplasia in patients with atrophic gastritis. Dig Dis Sci 2004; 49: 795–801.
38.
Choi YJ, Kim N, Yoon H, Shin CM, Park YS, Park JH, Nam RH, Lee DH, Jung HC: Increase in plasma acyl ghrelin levels is associated with abatement of dyspepsia following helicobacter pylori eradication. J Gastroenterol 2016; 51: 548–559.
39.
Kawashima J, Ohno S, Sakurada T, Takabayashi H, Kudo M, Ro S, Kato S, Yakabi K: Circulating acylated ghrelin level decreases in accordance with the extent of atrophic gastritis. J Gastroenterol 2009; 44: 1046–1054.
40.
Shin A, Camilleri M, Busciglio I, Burton D, Smith SA, Vella A, Ryks M, Rhoten D, Zinsmeister AR: The ghrelin agonist rm-131 accelerates gastric emptying of solids and reduces symptoms in patients with type 1 diabetes mellitus. Clin Gastroenterol Hepatol 2013; 11: 1453–1459 e1454.
41.
Yakabi K, Ro S, Onouhi T, Tanaka T, Ohno S, Miura S, Johno Y, Takayama K: Histamine mediates the stimulatory action of ghrelin on acid secretion in rat stomach. Dig Dis Sci 2006; 51: 1313–1321.
You do not currently have access to this content.