Sung Eun Kim1, Nayoung Kim2, Seon Mee Park3, Won Hee Kim4, Gwang Ho Baik5, Yunju Jo6, Kyung Sik Park7, Ju Yup Lee7, Ki-Nam Shim8, Gwang Ha Kim9, Bong Eun Lee9, Su Jin Hong10, Seon-Young Park11, Suck Chei Choi12, Jung Hwan Oh13, Hyun Jin Kim14. 1. Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea. 2. Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea. 3. Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea. 4. Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea. 5. Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea. 6. Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea. 7. Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea. 8. Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea. 9. Department of Internal Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. 10. Department of Internal Medicine and Research Institute, Soonchunhyang University College of Medicine, Bucheon, Korea. 11. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. 12. Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea. 13. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. 14. Department of Internal Medicine, Gyeongsang National University School of Medicine, Jinju, Korea.
Abstract
BACKGROUND/AIMS: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. METHODS: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. RESULTS: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. CONCLUSIONS: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.
BACKGROUND/AIMS: The predictive factors of functional dyspepsia (FD) remain controversial. Therefore, we sought to investigate symptom responses in FD patients after Helicobacter pylori (H. pylori) eradication and used predictive factor analysis to identify significant factors of FD resolution at one-year after commencing eradication therapy. METHODS: This prospective, multi-center clinical trial was performed on 65 FD patients that met Rome III criteria and had H. pylori infection. Symptom responses and factors that predicted poor response were determined by analysis one year after commencing H. pylori eradication therapy. RESULTS: A total of 63 patients completed the one-year follow-up. When an eradication success group (n=60) and an eradication failure group (n=3) were compared with respect to FD response rate at one year, results were as follows; complete response 73.3% and 0.0%, satisfactory response 1.7% and 0.0%, partial response 10.0% and 33.3%, and refractory response 15.0% and 66.7%, respectively (p=0.013). Univariate analysis showed persistent H. pylori infection (p=0.021), female gender (p=0.025), and medication for FD during the study period (p=0.013) were associated with poor FD response at one year. However, age, smoking, alcohol consumption, and underlying disease were not found to affect response. Finally, multivariate analysis showed that female gender (OR, 4.70; 95% CI, 1.17-18.88) was the sole independent risk factor of poor FD response at one year after commencing H. pylori eradication therapy. CONCLUSIONS: Female gender was found to predict poor response in FD patients despite H. pylori eradication. Furthermore, successful H. pylori eradication appears to be associated with FD improvement, but the number of non-eradicated patients was too small to conclude.