Health Questions and Answers

Question: Can infected people develop symptoms, even without a detectable ulcer?

Answer:

Functional (or nonulcer) dyspepsia is a poorly defined clinical entity, probably with multiple causes. Evidence that H. pylori gastritis causes dyspepsia in the absence of an ulcer has been difficult to obtain, because no specific symptoms separate H. pylori-related dyspepsia from other forms of functional dyspepsia. In addition, the effect of treatment for H. pylori infection on dyspeptic symptoms has been inconsistent. Nevertheless, a subset of patients with functional dyspepsia has symptoms certainly related to infection and responds to treatment. Unfortunately, at present, we cannot reliably identify such patients.

Reference: Spiegel B, Vakil N, Ofman J: Dyspepsia management strategies in primary care: A decision analysis of competing strategies. Gastroenterology 122:1270-1285, 2002.

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