Density of Gastric Helicobacter pylori Colonization Is Not Associated with Occurrence of Dyspeptic Symptoms

In most studies, the prevalence of Helicobacterpylori infection in patients with dyspeptic symptomsdoes not clearly differ from the prevalence inasymptomatic controls. However, the degree of H. pylori colonization might play a role for theoccurrence and severity of dyspeptic symptoms. BetweenAugust 1993 and July 1994, we screened 1500 apparentlyhealthy volunteers (1036 men, 464 women, 42 ± 12years) for H. pylori infection using the[¹³C] urea breath test. The noninvasive ureabreath test enables a semiquantitative assessment of theextent of H. pylori colonization in the stomach. Of the1500 volunteers, 526 (35.1%) complained of occasional orfrequent dyspeptic symptoms. No difference was observedin the H. pylori prevalence between asymptomaticsubjects (35.5%) and those with dyspeptic symptoms(35.9%; P > 0.95). A high density of H. pyloricolonization in the gastric mucosa was not associatedwith a higher frequency of dyspepsia (P > 0.80).According to these findings, an eradication therapy onthe basis of dyspeptic symptoms alone cannot berecommended as H. pylori is not a proven etiology ofdyspepsia.