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Ronald J. Schlemper, PhD; Sjoerd D. J. van der Werf, PhD; Jan P. Vandenbroucke, PhD; Izäk Biemond, PhD; Cornelis B. H. W. Lamers, PhD
Leiden, the Netherlands

Arch Intern Med. 1995;155(20):2254-2255.

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In reply

We thank Loffeld and Werdmuller for their interest in our article.¹ We took great care to find out whether Helicobacter pylori is associated in any way with nonulcer dyspepsia (NUD) by analyzing a subgroup of subjects with "essential dyspepsia." The presence of subjects with NUD from other identifiable causes might weaken a possible association with H pylori infection. Therefore, essential dyspepsia was defined as NUD in the absence of irritable bowel syndrome and regular nonsteroidal anti-inflammatory drug use, as well as in the absence of heartburn and/or acid regurgitation as the only frequent dyspeptic symptom(s). When heartburn or acid regurgitation clearly dominated a patient's complaints, these symptoms were shown to have a high specificity (85% and 96%) for gastroesophageal reflux disease.²

Loffeld and Werdmuller imply that we only defined a specific set of symptoms to determine whether H pylori plays a role in NUD. On the . . . [Full Text PDF of this Article]

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