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      Helicobacter pylori infection status had no influence on upper gastrointestinal symptoms: a cross-sectional analysis of 3,005 Japanese subjects without upper gastrointestinal lesions undergoing medical health checkups

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          Abstract

          Background

          This study aimed to evaluate the influence of Helicobacter pylori infection and its eradication on the upper gastrointestinal symptoms of relatively healthy Japanese subjects.

          Methods

          A total of 3,005 subjects (male/female: 1,549/1,456) undergoing medical health checkups were enrolled in the present study, at five hospitals in Saga, Japan, from January to December 2013. They had no significant findings following upper gastrointestinal endoscopy. All subjects completed a questionnaire that addressed a frequency scale for symptoms of gastroesophageal reflux disease. The questionnaire comprised seven questions regarding reflux symptoms and seven regarding acid-related dyspepsia, which were answered with a score based on the frequency of symptoms. Helicobacter pylori infection was identified by a rapid urease test and/or H. pylori antibody titer, and an eradication history was confirmed by the subjects’ medical records.

          Results

          Helicobacter pylori infection was positive in 894 subjects out of 3,005 (29.8%). Eradication of Helicobacter pylori was successfully achieved in 440 subjects of 458 treated. Helicobacter pylori infection had no influence on the acid-related dyspepsia evaluated by the questionnaire, whereas the mean reflux score was relatively high in the Helicobacter pylori native negative subjects compared to Helicobacter pylori native positive. Eradication of Helicobacter pylori and time span after the eradication had no effect on the upper gastrointestinal symptoms evaluated by the questionnaire.

          Conclusion

          Helicobacter pylori infection and history of eradication did not affect acid-related dyspepsia symptoms in Japanese healthy subjects.

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          Most cited references24

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          Rome IV Diagnostic Questionnaires and Tables for Investigators and Clinicians.

          The Rome IV Diagnostic Questionnaires were developed to screen for functional gastrointestinal disorders (FGIDs), serve as inclusion criteria in clinical trials, and support epidemiological surveys. Separate questionnaires were developed for adults, children/adolescents, and infants/toddlers. For the adult questionnaire, we first surveyed 1,162 adults without gastrointestinal disorders, and recommended the 90(th) percentile symptom frequency as the threshold for defining what is abnormal. Diagnostic questions were formulated and verified with clinical experts using a recursive process. The diagnostic sensitivity of the questionnaire was tested in 843 patients from 9 gastroenterology clinics, with a focus on clinical diagnoses of irritable bowel syndrome (IBS), functional constipation (FC), and functional dyspepsia (FD). Sensitivity was 62.7% for IBS, 54.7% for FD, and 32.2% for FC. Specificity, assessed in a population sample of 5,931 adults, was 97.1% for IBS, 93.3% for FD, and 93.6% for FC. Excess overlap among IBS, FC, and FD was a major contributor to reduced diagnostic sensitivity, and when overlap of IBS with FC was permitted, sensitivity for FC diagnosis increased to 73.2%. All questions were understandable to at least 90% of individuals, and Rome IV diagnoses were reproducible in ¾ of patients after one month. Validation of the pediatric questionnaires is ongoing.
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            Functional Dyspepsia.

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              Development and evaluation of FSSG: frequency scale for the symptoms of GERD.

              The aim of this study was to produce a simplified questionnaire for evaluation of the symptoms of gastroesophageal reflux disease (GERD). A total of 124 patients with an endoscopic diagnosis of GERD completed a 50-part questionnaire, requiring only "yes" or "no" answers, that covered various symptoms related to the upper gastrointestinal tract, as well as psychosomatic symptoms. The 12 questions to which patients most often answered "yes" were selected, and were assigned scores (never = 0; occasionally = 1; sometimes = 2; often = 3; and always = 4) to produce a frequency scale for symptoms of GERD (FSSG). Sensitivity, specificity, and accuracy of the FSSG questionnaire were evaluated in another group of patients with GERD and non-GERD. The usefulness of this questionnaire was evaluated in 26 other GERD patients who were treated with proton pump inhibitors for 8 weeks. When the cutoff score was set at 8 points, the FSSG showed a sensitivity of 62%, a specificity of 59%, and an accuracy of 60%, whereas a cutoff score of 10 points altered these values to 55%, 69%, and 63%. The score obtained using the questionnaire correlated well with the extent of endoscopic improvement in patients with mild or severe GERD. This new questionnaire is useful for the objective evaluation of symptoms in GERD patients.
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                Author and article information

                Contributors
                +81-952-31-6511 , fujimotk@cc.saga-u.ac.jp
                Journal
                Esophagus
                Esophagus
                Esophagus
                Springer Japan (Tokyo )
                1612-9059
                1612-9067
                15 March 2017
                15 March 2017
                2017
                : 14
                : 3
                : 249-253
                Affiliations
                [1 ]ISNI 0000 0001 1172 4459, GRID grid.412339.e, Department of Internal Medicine, , Saga Medical School, ; 5-1-1 Nabeshima, Saga, 849-8501 Japan
                [2 ]ISNI 0000 0001 1172 4459, GRID grid.412339.e, Department of Gastrointestinal Endoscopy, , Saga Medical School, ; Saga, Japan
                [3 ]ISNI 0000 0001 1172 4459, GRID grid.412339.e, Department of Preventive Medicine, , Saga Medical School, ; Saga, Japan
                [4 ]Yuaikai Oda Hospital, Kashima, Saga Japan
                [5 ]Saiseikai Karatsu Hospital, Karatsu, Saga Japan
                [6 ]Takagi Hospital, Okawa, Fukuoka Japan
                [7 ]ISNI 0000 0004 0595 7039, GRID grid.411887.3, Department of Endoscopic Surgery, , Gunma University Hospital, ; Maebashi, Japan
                Article
                573
                10.1007/s10388-017-0573-9
                5486453
                b93e5df7-a3c3-4e9f-9d39-bb57ca46da78
                © The Author(s) 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 26 October 2016
                : 1 March 2017
                Categories
                Original Article
                Custom metadata
                © The Japan Esophageal Society and Springer Japan KK 2017

                Otolaryngology
                reflux esophagitis,gastroesophageal reflux disease (gerd),reflux symptoms,functional dyspepsia,frequency scale for the symptoms of gerd (fssg)

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