Effect of Helicobacter pylori eradication on gastric emptying and symptoms in patients with dyspepsia

Aim: To study whether eradication of Helicobacter pylori (H. pylori) in patients with functional dyspepsia affects gastric emptying (GE) and concomitantly relieves their clinical symptoms. Material and methods: Eighteen H. pylori-positive patients suffering from functional dyspepsia were recruited. At entrance and two weeks after successful H. pylori eradication they filled in a questionnaire examining the intensity of dyspeptic symptoms and underwent measurement of GE of a 378 kcal solid test meal labelled with 75 mu l of (13)C-octanoic acid. Normative values of GE were obtained in 12 healthy controls. Results: Helicobacter pylori eradication was attained in 17 patients. The duration of the lag phase (T_Lag) of the GE did not change after the eradication (mean +/- SD 144.5 +/- 23.2 min) vs. before the eradication (152.1 +/- 27.6 min). On the other hand, the gastric half emptying time (T(1/2)) increased statistically significantly from 207.1 +/- 33.5 min before eradication to 229.5 +/- 49.4 min (p = 0.0217). Considering the whole patient group, the H. pylori eradication did not significantly affect the dyspeptic symptoms. It was established, however, that the deterioration of the score for fullness or satiety was dependent on the increase in the T_Lag. Also the aggravation of pain, burning or satiety was related to the prolongation of the T(1/2). Conclusions: 1) Eradication of H. pylon in patients with functional dyspepsia prolongs the gastric half emptying time of a solid meal without eliciting a significant symptomatic improvement. 2) The worsening of dyspeptic symptoms may be related to sluggish gastric emptying.