InH pylori-positive patients with nonulcer dyspepsia, is eradication therapy better than PPI therapy for preventing long-term symptom recurrence?

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Evidence-Based Answer

Yes. Attempted eradication with antibiotics and acid suppression decreases dyspepsia symptoms 12 months after treatment to a greater degree than placebos, proton pump inhibitors (PPIs), or prokinetic therapy (SOR: B, meta-analysis of RCTs that did not include PPIs in every trial arm). One year after treatment, clinical improvement with antibiotics and PPIs compared with PPIs alone was increased by an absolute 7% to 14% (SOR: C, 4 small RCTs that did not always reach statistical significance).

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