Hp test and treat strategy reduces both disease-related absenteeism from work, house-doctor consultations and antacid consumption in uninvestigated chronic dyspeptic staff members of a large factory

Helicobacter pylori (H. pylori) infection can be diagnosed by invasive techniques requiring endoscopy and biopsy (histological examination, culture, polymerase chain reaction) and by noninvasive techniques (serology, urea breath test, urine or blood, detection of H. pylori antigen in stool specimen). At present, no single test can be absolutely relied upon to detect colonization by H. pylori, and a combination of two tests is recommended if feasible. The tests used should depend on the clinical circumstances, the likelihood ratio of positive and negative tests, the cost‐effectiveness of the testing strategy, and the availability of the tests. Some clinical circumstances warrant invasive studies, principally patients with alarm symptoms (bleeding, weight loss, etc.) as well as older patients with new‐onset dyspepsia. Endoscopy may also be advisable in patients who have failed eradication therapy and need culture and antimicrobial sensitivity testing to determine an appropriate regimen. Recent studies have also demonstrated that a strategy to `test and treat' for H. pylori in uninvestigated, young (< 50 years), dyspeptic patients in primary care is safe and reduces the need for endoscopy. Indeed, a number of clinical guidelines recommend noninvasive testing followed by treatment of H. pylori for dyspeptic patients in primary care based on clinical and economic analyses.

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“…antacid consumption, house doctor consultations) and indirect costs (i.e. absenteeism from work) 51 . Spiegel et al .…”

Section: Noninvasive Tests In Clinical Practicementioning

confidence: 99%

Diagnosis of Helicobacter pylori infection

Vaira

Gatta

Ricci

et al. 2002

Aliment Pharmacol Ther

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“…antacid consumption, house doctor consultations) and indirect costs (i.e. absenteeism from work) [41]. The cost‐effectiveness of diagnostic testing was evaluated recently in an economic model.…”

Section: Discussionmentioning

confidence: 99%

Non-invasive techniques for the diagnosis of Helicobacter pylori infection

Gatta¹,

Ricci²,

Tampieri³

et al. 2003

Clinical Microbiology and Infection

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Helicobacter pylori infection can be diagnosed by invasive techniques requiring endoscopy and biopsy (histologic examination, culture, polymerase chain reaction), and non-invasive techniques (serology, urea breath test, urine or blood, detection of H. pylori antigen in stool specimen). However, recent studies have demonstrated that a strategy of 'testing and treating' for H. pylori in uninvestigated, young (<50 years), dyspeptic patients in primary care is safe and reduces the need for endoscopy. Indeed, a number of clinical guidelines recommend non-invasive testing in dyspeptic patients followed by treatment of H. pylori in primary care based on clinical and economic analyses. Several non-invasive tests are currently available on the market. The choice depends on the clinical circumstances, the likelihood ratio of positive and negative tests, the cost-effectiveness of the testing strategy, and, finally, the availability of the tests. Nevertheless, two non-invasive tests are commonly used: the urea breath test, and the stool antigen test.

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“…Madisch et al . measured the effect of an H. pylori test and treat strategy on health resource utilization in a factory setting 14 . He was able to show that absenteeism, consultations and antacid use were significantly ( P < 0.05) less in the H. pylori cured group vs. the H. pylori ‐negative control patients.…”

Section: Controlled Clinical Trials Evaluating Initial Management Strmentioning

confidence: 99%

Helicobacter pylori and uninvestigated dyspepsia

Fennerty

2002

Aliment Pharmacol Ther

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Although dyspepsia is a very common disorder, the incidence of Helicobacter pylori infection in Western medical clinics is very low (20–35%). In cases where H. pylori is detected, elimination of it may be cost‐effective in the long term, but even eradication is not a guarantee for long‐term relief. Further studies to determine the connection between H. pylori and dyspepsia need to be completed before H. pylori eradication becomes the treatment of choice for that minority of patients. The majority of dyspeptic patients are not as simple to diagnose, and may need several empirical trials of therapy, or more specific diagnostic assessment.

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Hp test and treat strategy reduces both disease-related absenteeism from work, house-doctor consultations and antacid consumption in uninvestigated chronic dyspeptic staff members of a large factory

Cited by 4 publications

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Diagnosis of Helicobacter pylori infection

Diagnosis of Helicobacter pylori infection

Non-invasive techniques for the diagnosis of Helicobacter pylori infection

Helicobacter pylori and uninvestigated dyspepsia

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