Effect of Helicobacter pylori on gastric emptying in non-ulcer dyspepsia. —Evaluation of Helicobacter pylori by ¹³C-urea breath test—

Abstract

AIM: Non-ulcer dyspepsia (NUD) is a common disorder in clinical field. The pathogenesis of NUD are still unclear, especially the participation of Helicobacter pylori (H. pylori) in NUD is controversy. Aim of the present study was to clarify the effect of H. pylori at view of urea breath test on liquids and solids gastric emptying in patients with NUD. SUBJECTS AND METHODS: H. pylori positive (n=24) and negative NUD subjects (n=11), and H. pylori positive non-NUD subjects (n=10) as control group were studied. Liquids and solids gastric emptying was evaluated according to the acetaminophen method and sulfamethzole modified method. δ¹³C-AUC was calculated as estimation of H. pylori by ¹³C-urea breath test. H.pylori positive NUD was classified into high δ¹³C-AUC group (n=11), median group (n=8) and low group (n=5). High δ¹³C-AUC group (n=6) and low δ¹³C-AUC group (n=4) group were treated by eradication therapy. In H. pylori positive NUD subjects, high and low δ¹³C-AUC group were estimated the changes of liquids and solids gastric emptying, symptoms before and after eradication. RESULTS: H. pylori positive NUD group has higher liquids gastric emptying that H. pylori negative NUD group (7.6±2.8 vs. 4.9±1.4, p=0.0022). No difference was observed between H. pylori positive and H. pylori negative group on solids gastric emptying. There was no significant difference in liquids gastric emptying among high-, median- and low-δ¹³C-AUC group of H. pylori positive NUD subjects. Solids gastric emptying was significantly delayed in high δ¹³C-AUC group, compared with low δ¹³C-AUC group (10.3±3.7 vs. 5.3±3.1, p=0.014). δ¹³C-AUC was not correlated to liquids gastric emptying, but to solids gastric emptying (r=−0.573. p=0.006). In Non-NUD group as control group, δ¹³C-AUC has not correlation to liquids and solids gastric emptying. H.pylori positive NUD has higher δ¹³C-AUC than Non-NUD group. Eradicated low δ¹³C-AUC group did not show significant changes in liquids gastric emptying, but did improvement of solids gastric emptying and symptoms scores. Eradicated low δ¹³C-AUC group did not show any significant changes. CONCLUSION: In non-ulcer dyspepsia patients. H. pylori does not influence liquids gastric emptying, but does solids gastric emptying according to δ¹³C-AUC of H. pylori, especially high δ¹³C-AUC patients.