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Therapy for Helicobacter pylori in Patients with Nonulcer Dyspepsia: A Meta-Analysis of Randomized, Controlled Trials

Loren Laine, MD; Philip Schoenfeld, MD, MSEd, MSc; and M. Brian Fennerty, MD
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From University of Southern California School of Medicine, Los Angeles, California; University of Michigan School of Medicine and Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan; and Oregon Health Sciences University, Portland, Oregon.

Acknowledgments: The authors thank Bruce Weaver, MSc, of the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, for statistical support.

Current Author Addresses: Dr. Laine: Gastrointestinal Division, Department of Medicine, University of Southern California School of Medicine, 2025 Zonal Avenue, Los Angeles, CA 90033.

Dr. Schoenfeld: Division of Gastroenterology, University of Michigan School of Medicine, and Division of Health Services Research, Ann Arbor Veterans Affairs Medical Center, VAMC 111-D, 2215 Fuller Road, Ann Arbor, MI 48105.

Dr. Fennerty: Division of Gastroenterology (PV-310), Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97201.

Author Contributions: Conception and design: L. Laine, P. Schoenfeld, M.B. Fennerty.

Analysis and interpretation of the data: L. Laine, P. Schoenfeld, M.B. Fennerty.

Drafting of the article: L. Laine, P. Schoenfeld, M.B. Fennerty.

Critical revision of the article for important intellectual content: L. Laine, P. Schoenfeld, M.B. Fennerty.

Final approval of the article: L. Laine, P. Schoenfeld, M.B. Fennerty.

Provision of study materials or patients: L. Laine, M.B. Fennerty.

Statistical expertise: L. Laine, P. Schoenfeld.

Administrative, technical, or logistic support: L. Laine, P. Schoenfeld.

Collection and assembly of data: L. Laine, M.B. Fennerty.

Ann Intern Med. 2001;134(5):361-369. doi:10.7326/0003-4819-134-5-200103060-00008
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Dyspepsia, defined as pain or discomfort centered in the upper abdomen (13), is extremely common. The annual prevalence of dyspepsia in the United States and western countries is approximately 25%, and it may account for up to 5% of visits to primary care providers (2). The definition of dyspepsia requires predominant symptoms centered in the upper abdomen (23). Predominant symptoms of heartburn (burning retrosternal pain) suggest gastroesophageal reflux disease and exclude a diagnosis of dyspepsia (23).

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Treatment success forHelicobacter pyloritherapy compared with control therapy.

Odds ratios for individual trials and summary odds ratios for all trials and trials that used specific definitions of dyspepsia (predominant symptoms of upper abdominal pain or discomfort).

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Summary for Patients

Combination Therapies Commonly Used for Stomach Ulcers Are Probably Not Useful for Treating Stomach Discomfort

The summary below is from the full report titled “Therapy for Helicobacter pylori in Patients with Nonulcer Dyspepsia. A Meta-Analysis of Randomized, Controlled Trials.” It is in the 6 March 2001 issue of Annals of Internal Medicine (volume 134, pages 361-369). The authors are L Laine, P Schoenfeld, and MB Fennerty.


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