Long-Term Outcome Of Patients With Functional Dyspepsia Infected With A Cag-Positive Helicobacter Pylori Strain. A Descriptive Study

Introduction: An important virulence factor of H.pylori is the Cagpathogenicity island. The clinical sequel in patients with functional dyspepsia treated for H.pylori on the long-term is not known. Aim: Establish long-term outcome and relate this to the initial H.pylori status (CagApositive or negative). Patients and Methods: In 1994/1995 a study on presence of H.pylori was done. IgG antibodies against cagA were determined. Three groups of patients were made: group 1: H.pylori + and CagA+; group 2: H.pylori + and CagA-; and group 3: H.pylori -patients. An extensive chart review and several questionnaires were used (a general questionnaire, the GerdQ, theSAI, and, the GSRS). Use of acid suppressive drugs was assessed. Results: 411 patients were included. New upper GI-endoscopies were significantly more often done in patients of group 1 (p<0.001). Reflux disease was significantly more often diagnosed in group 1 patients (p=0.02). After exclusions 239 patients (58.2%) received the questionnaires, 101 respondents were evaluable. Patients in group 1 reported significantly more often complaints. There was no significant difference in the overall presentation when patients of group 1 were compared with patients of group 2. However, there was a significant difference between the scores in H.pylori+ patients when compared with patients of group 3. Patients of group 1 significantly used more often acid suppressive therapy. Conclusion: functional dyspeptics with H.pylori CagA+strain, may develop more often complaints in the future necessitating a new endoscopic investigations. Signs of reflux disease are more often present. Key-words: Dyspepsia; H.pylori; Cag-A; Follow-up; Upper Gastrointestinal Endoscopy