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Nonulcer Dyspepsia and Helicobacter pylori: Causal or Coincidental?

R. J. L. F. Loffeld, MD, PhD; B. F. M. Werdmuller, MD
Arch Intern Med. 1995;155(20):2253-2254. doi:10.1001/archinte.1995.00430200155019.
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We read with great interest the article by Schlemper et al1 that appeared in the January 9, 1995, issue of the ARCHIVES. The authors studied the prevalence of IgG Helicobacter pyloriantibodies and dyspeptic symptoms in a selected group of the Dutch working population and conclude that nonulcer dyspepsia (NUD) is not related to H pylori infection.

After reading the introduction, it is obvious that Schlemper and colleagues do not believe that H pylori plays a role in NUD. The only purpose of their study seems to be the validation of this assumption. Their article presents an epidemiologic study; therefore, conclusions regarding individuals are not warranted. In our opinion, there are several flaws that make the final conclusion doubtful.

The authors state: "Only a few studies investigated unselected individuals, as we have done. Most investigators studied patients referred for endoscopy." This is an important point. Case notes were verified


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