Helicobacter pylori Infection Impacts on Functional Dyspepsia in Thailand

Background: Helicobacter pylori (H. pylori) is a well known major cause of gastric cancer and even whenasymptomatic infected patients are at elevated risk. Functional dyspepsia (FD) is also one of the most commongastrointestinal diseases, which greatly impacts the quality of life. H. pylori infection and psychosocial stress arefrequently associated with FD but limited studies have confirmed the relationships, especially in Southeast Asiancountries. Here we aimed to investigate the prevalence and impact of H. pylori infection, anxiety and depressionon Thai FD patients. Materials and
Methods: This cross-sectional study was conducted in a tertiary care centerin Thailand, during February 2013-January 2014. All FD patients were diagnosed and categorized by Rome IIIcriteria into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS) groups. The HospitalAnxiety and Depression Scale was used to evaluate psychological status. The presence of H. pylori was definedas positive with H. pylori culture, positive rapid urease test or positive histology.
Results: Three hundred FDpatients were included, 174 (58%) female. Overall mean age was 54.8+15.1 years. There were 192 (64%) patientswith PDS and 108 (36%) with EPS. H. pylori infection was demonstrated in 70 (23.3%) patients. Anxiety anddepression were documented in 69 (23%) and 22 (7.3%), respectively. H. pylori infection, anxiety and depressionwere significantly higher in PDS than EPS patients (27.1% vs 16.7%; p=0.04; OR=1.86; 95%CI=1.01-3.53 and29.7% vs 11.1%; p=0.0002; OR=3.4; 95%CI=1.7-7.1 and 10.4% vs 1.9%; p=0.006; OR=6.2; 95%CI=1.4-38.9,respectively).
Conclusions: H. pylori infection, anxiety and depression were commonly found in Thai FD patientsand more prevalent in PDS than EPS. H. pylori eradication might be the key to success for the treatment of ThaiFD patients and prevent the development of gastric cancer.