Helicobacter pylori “test-and-scope” strategy for dyspeptic patients. Is it useful and safe?

Gisbert, Javier P.; Cruzado, A.I.; Benito, Lm; Carpio, Daniel; Perez-Poveda, Jj; González, Leticia; Pedro, A. de; Valbuena, Marta Ruiz de; Prieto, B.; Cabrera, M; Cantero, José L.; Jm, Pajares García

doi:10.1016/s1590-8658(01)80104-3

Cited by 5 publications

(4 citation statements)

References 49 publications

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“…This ‘test and treat’ strategy with UBT or serology was evaluated by Gisbert et al. in Spain [84]. At the threshold age of 45 years, using UBT, 15% of all endoscopies would have been saved (while one gastric ulcer and two esophagites would have been missed); the corresponding figure for serology is 21%; and for CagA serology, 31%.…”

Section: Diagnosismentioning

confidence: 99%

Epidemiology and diagnosis of Helicobacter pylori infection

Mitchell

Mégraud

2002

Helicobacter

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There have been no major breakthroughs in the field of epidemiology and diagnosis of Helicobacter pylori infection over the last year, thus for this reason, these two topics will be treated in the same chapter. Information on the incidence of infection, as in the study of Malaty et al. are now being published from long-term cohort follow-ups. The route of transmission of H. pylori remains controversial, with circumstantial evidence for infection via exposure to animals, contaminated water supplies and oral reservoirs being reported. The value of citric acid to improve urea breath test (UBT) results has been documented. A novel stool test has been released on the market and we are awaiting more information, while detection of antibodies in urine gave satisfactory results. However, the most interesting data comes from the study of McColl et al. who clearly proved on a large sample and a 1-year follow-up that the 'test and treat' strategy using UBT, as proposed in the Maastricht Consensus Report, is definitely the method to use.

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Section: Diagnosismentioning

confidence: 99%

Epidemiology and diagnosis of Helicobacter pylori infection

Mitchell

Mégraud

2002

Helicobacter

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“…Symptomatic treatment, on the other hand, could be given to non-infected patients. The test-and-scope strategy 13, 14 —performing a test to detect H. pylori in all patients and endoscopy only in those who are shown to be infected—has been considered less useful and is therefore not applied in clinical practice. 13, 14 …”

Section: Introductionmentioning

confidence: 99%

Helicobacter Pylori “Test-and-Treat” Strategy for Management of Dyspepsia: A Comprehensive Review

Gisbert

Calvet

2013

Clinical and Translational Gastroenterology

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OBJECTIVES:Deciding on whether the Helicobacter pylori test-and-treat strategy is an appropriate diagnostic–therapeutic approach for patients with dyspepsia invites a series of questions. The aim present article addresses the test-and-treat strategy and attempts to provide practical conclusions for the clinician who diagnoses and treats patients with dyspepsia.METHODS:Bibliographical searches were performed in MEDLINE using the keywords Helicobacter pylori, test-and-treat, and dyspepsia. We focused mainly on data from randomized controlled trials (RCTs), systematic reviews, meta-analyses, cost-effectiveness analyses, and decision analyses.RESULTS:Several prospective studies and decision analyses support the use of the test-and-treat strategy, although we must be cautious when extrapolating the results from one geographical area to another. Many factors determine whether this strategy is appropriate in each particular area. The test-and-treat strategy will cure most cases of underlying peptic ulcer disease, prevent most potential cases of gastroduodenal disease, and yield symptomatic benefit in a minority of patients with functional dyspepsia. Future studies should be able to stratify dyspeptic patients according to their likelihood of improving after treatment of infection by H. pylori.CONCLUSIONS:The test-and-treat strategy will cure most cases of underlying peptic ulcer disease and prevent most potential cases of gastroduodenal disease. In addition, a minority of infected patients with functional dyspepsia will gain symptomatic benefit. Several prospective studies and decision analyses support the use of the test-and-treat strategy. The test-and-treat strategy is being reinforced by the accumulating data that support the increasingly accepted idea that “the only good H. pylori is a dead H. pylori”.

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“…Gastroscopia in caso di mancata risposta Test and scope: test non invasivo per HP a tutti i pazienti e gastroscopia per quelli HP positivi, terapia empirica per quelli HP negativi Quest'ultima strategia non si è rivelata vantaggiosa in quanto aumenta i costi senza vantaggi in ter-mini di riduzione dei sintomi e di miglioramento della qualità della vita. Inoltre riduce solo del 15-20% il numero delle gastroscopie richieste (15). Per quanto attiene alla strategia "test and treat", invece, quattro trials randomizzati hanno dimostrato pari efficacia rispetto alla endoscopia immediata.…”

Section: Gestione Pratica Del Pazienteunclassified

Dispepsia ed Helicobacter pylori

Fornaciari¹

2003

Microbiol Med

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Helicobacter pylori “test-and-scope” strategy for dyspeptic patients. Is it useful and safe?

Cited by 5 publications

References 49 publications

Epidemiology and diagnosis of Helicobacter pylori infection

Epidemiology and diagnosis of Helicobacter pylori infection

Helicobacter Pylori “Test-and-Treat” Strategy for Management of Dyspepsia: A Comprehensive Review

Dispepsia ed Helicobacter pylori

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