Efficacy of Helicobacter pylori eradication followed by the administration of a proton pump inhibitor (PPI) or PPI plus a prokinetic in H. pylori-positive patients with dyspepsia

Abstract

 To investigate whether treatment comprised of Helicobacter pylori eradication followed by the administration of a proton pump inhibitor (PPI) alone and a dual treatment with a PPI plus a prokinetic agent helps relieve symptoms, we treated 26 patients with H. pylori infection and dyspepsia with the sequential treatment and assessed their symptoms. Scores for gastroesophageal reflux disease (GERD) and dyspepsia in a modified F-scale were significantly improved after the eradication of H. pylori, and symptoms were completely relieved in 13 patients. The remaining 13 patients received 4-week treatment with the PPI rabeprazole, and their GERD scores significantly improved after the treatment. The symptoms of five patients completely disappeared ; the other eight patients required dual treatment with a PPI plus the prokinetic acotiamide. Early satiety tended to be relieved after the dual treatment, but the improvement was not significant. Thus, in patients with dyspepsia and an H. pylori infection, the H. pylori should be eradicated first. The administration of a PPI is useful in patients with GERD symptoms, and a PPI+ acotiamide may be beneficial for residual symptoms of early satiety.