Impact of Helicobacter pylori Eradication Therapy on Gastrointestinal Symptom Relief and Quality of Life in Dyspeptic Patients

Abstract

Background: Dyspepsia occurs frequently and often has been attributed to Helicobacter pylori infection. Randomized trial results indicate variable benefit of eradication therapy regarding symptoms and quality of life, and meta-analyses indicate only slight benefit on average. Objective: To evaluate the effect of H. pylori eradication therapy on the treatment of gastrointestinal symptoms, quality of life, and microbiologic eradication of H. pylori in H. pylori seropositive dyspeptic patients in the secondary care setting of South Asia. Methods: In this parallel group randomized controlled trial at the Iqra Hospital in Lahore, Pakistan, a total of 60 consenting adult volunteers aged 18-65 years old and experiencing dyspepsia for at least three months with biopsy-confirmed H. pylori infections were randomly allotted 1:1 to the treatment arm involving standard eradication therapy consisting of the standard triple regimen administered for two weeks versus the standard non-eradication therapy regimen. The end points assessed at the four- to eight-week post-therapy interval included global dyspepsia severity using the 0-to-10 numeric rating scale, symptoms' frequency of occurrence (mean number of episodes per week), gastrointestinal quality of life using the 0-to-100 visual analogue scale, and patient global assessments of overall wellness graded from 1 to 5. Intention-to-treat statistical analysis used t-testing. Results: Eradication therapy reduced global dyspepsia symptoms more than control (mean difference in post-treatment scores: 3.9 vs 5.8, p < 0.001) and improved total quality of life score (mean difference: 8.3, p = 0.002). H. pylori cure rates were 67% vs 10% (risk difference: 0.57). Adverse event rates were higher but mild. Conclusion: In H. pylori-positive dyspeptic patients in Pakistan, treatment achieves marked benefits in symptoms and quality of life when compared to conventional management and has a high rate of eradication and acceptable tolerance.