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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2026; 32(6): 115699
Published online Feb 14, 2026. doi: 10.3748/wjg.v32.i6.115699
Published online Feb 14, 2026. doi: 10.3748/wjg.v32.i6.115699
Dyspepsia following Helicobacter pylori eradication: Shifts in etiology and clinical challenges
Jian-Guo Lu, Yi-Zhou Gao, Department of Environmental Hygiene, School of Public Health, Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Jian-Guo Lu, Yi-Zhou Gao, Key Laboratory of Precision Nutrition and Health, Ministry of Education, Harbin Medical University, Harbin 150081, Heilongjiang Province, China
Author contributions: Lu JG is responsible for the concept conception and initial draft writing; Gao YZ is responsible for supervision, guidance and review.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Zhou Gao, PhD, Professor, Department of Environmental Hygiene, School of Public Health, Harbin Medical University, No. 157 Baojian Road, Nangang Distinct, Harbin 150081, Heilongjiang Province, China. gaoyizhou@yeah.net
Received: October 22, 2025
Revised: December 14, 2025
Accepted: December 23, 2025
Published online: February 14, 2026
Processing time: 102 Days and 20.9 Hours
Revised: December 14, 2025
Accepted: December 23, 2025
Published online: February 14, 2026
Processing time: 102 Days and 20.9 Hours
Core Tip
Core Tip: Although Japan has made significant progress in Helicobacter pylori eradication and gastric cancer deaths have declined annually, many patients still suffer from dyspepsia. This challenges the traditional “test-and-eradicate” approach and places a heavy burden on patients. Suzuki et al’s large-scale study (n = 23250) revealed similar post-eradication dyspepsia prevalence (28.7%) to that in uninfected individuals, suggesting a shift from infection to functional factors, such as gastric acid secretion and visceral hypersensitivity. These findings call for individualized symptom-based management, rather than repeated eradication.