Effect of population screening and treatment for Helicobacter pylori on dyspepsia and quality of life in the community: a randomised controlled trial
2000; Elsevier BV; Volume: 355; Issue: 9216 Linguagem: Inglês
10.1016/s0140-6736(00)02236-4
ISSN1474-547X
AutoresPaul Moayyedi, Richard Feltbower, Julia Brown, Suzanne Mason, James Mason, Jackie Nathan, ID Gerald Richards, Anthony Dowell, Anthony Axon,
Tópico(s)Eosinophilic Esophagitis
ResumoBackground Infection with Helicobacter pylori is the main cause of peptic-ulcer disease. Treatment of this infection might lower the prevalence of dyspepsia in the community and improve quality of life. We investigated this possibility in a double-blind randomised controlled trial. Methods Individuals aged 40–49 years were randomly selected from the lists of 36 primary-care centres. A researcher interviewed participants with a validated dyspepsia questionnaire and the psychological general wellbeing index (PGWB). H pylori status was assessed by the carbon-13-labelled urea breath test. Infected participants were randomly assigned active treatment (omeprazole 20 mg, clarithromycin 250 mg, and tinidazole 500 mg, each twice daily for 7 days) or identical placebo. Participants were followed up at 6 months and 2 years. Findings Of 32 929 individuals invited, 8455 attended and were eligible; 2324 were positive for H pylori and were assigned active treatment (1161) or placebo (1163). 1773 (76%) returned at 2 years. Dyspepsia or symptoms of gastro-oesophageal reflux were reported in 247 (28%) of 880 in the treatment group and 291 (33%) of 871 in the placebo group (absolute-risk reduction 5% [95% CI 1–10]). H pylori treatment had no significant effect on quality of life (mean difference in PGWB score between groups 0·86 [−0·33 to 2·05]). Interpretation Community screening and treatment for H pylori produced only a 5% reduction in dyspepsia. This small benefit had no impact on quality of life.
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