The Helicobacter pylori breath test: a surrogate marker for peptic ulcer disease in dyspeptic patients.

McColl, Kenneth E.L.; El-Nujumi, A.; Murray, Lilian S.; El-Omar, Emad; Gillen, Derek; Dickson, Anthea; Kelman, Andrew W.; Hilditch, T. E.

doi:10.1136/gut.40.3.302

Cited by 83 publications

(54 citation statements)

References 9 publications

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“…50% of smokers had a peptic ulcer 30 , suggesting that a substantial proportion of infected dyspeptics do have peptic ulcer disease. McColl was able to replicate these findings and detected peptic ulcer in an even higher proportion of H. pylori positive dyspeptics 31 . This makes it likely that a high proportion of dyspeptics with H. pylori at the point of referral for endoscopy will benefit from H. pylori eradication treatment.…”

Section: Role Of H Pylori In Dyspepsia and Non-ulcer-dyspepsiasupporting

confidence: 57%

Clinical practice - strategies for management of dyspepsia

Zar

Mendall

1998

British Medical Bulletin

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Section: Role Of H Pylori In Dyspepsia and Non-ulcer-dyspepsiasupporting

confidence: 57%

Clinical practice - strategies for management of dyspepsia

Zar

Mendall

1998

British Medical Bulletin

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“…4 19 Among those with uninvestigated dyspepsia who are H pylori positive, a substantial number will have peptic ulcer disease. 20 Endoscopy can now generally be reserved for patients who present with symptoms for the first time in older age or who have alarm features such as weight loss, vomiting, dysphagia, or bleeding that strongly suggest structural disease may be present. 4 …”

Section: Uninvestigated Dyspepsiamentioning

confidence: 99%

Functional Gastroduodenal Disorders

Tack¹,

et al. 2006

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While widely used in research, the 1991 Rome criteria for the gastroduodenal disorders, especially symptom subgroups in dyspepsia, remain contentious. After a comprehensive literature search, a consensus-based approach was applied, supplemented by input from international experts who reviewed the report. Three functional gastroduodenal disorders are defined. Functional dyspepsia is persistent or recurrent pain or discomfort centered in the upper abdomen; evidence of organic disease likely to explain the symptoms is absent, including at upper endoscopy. Discomfort refers to a subjective, negative feeling that may be characterized by or associated with a number of non-painful symptoms including upper abdominal fullness, early satiety, bloating, or nausea. A dyspepsia subgroup classification is proposed for research purposes, based on the predominant (most bothersome) symptom: (a) ulcer-like dyspepsia when pain (from mild to severe) is the predominant symptom, and (b) dysmotility-like dyspepsia when discomfort (not pain) is the predominant symptom. This classification is supported by recent evidence suggesting that predominant symptoms, but not symptom clusters, identify subgroups with distinct underlying pathophysiological disturbances and responses to treatment. Aerophagia is an unusual complaint characterized by air swallowing that is objectively observed and troublesome repetitive belching. Functional vomiting refers to frequent episodes of recurrent vomiting that is not self-induced nor medication induced, and occurs in the absence of eating disorders, major psychiatric diseases, abnormalities in the gut or central nervous system, or metabolic diseases that can explain the symptom. The current classification requires careful validation but the criteria should be of value in future research. (Gut 1999;45(Suppl II):II37-II42)

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“…Testing for H. pylori followed by treatment with eradication therapy for positive individuals ('test and treat') is another option, and the efficacy of this approach is thought to arise from a combination of successful treatment of latent peptic ulcer disease [37] , as well as a modest effect on the symptoms of functional dyspepsia [38] . The final strategy is one of empirical acid suppression therapy with either a proton pump inhibitor (PPI) or an H 2 -receptor antagonist (H 2 RA).…”

Section: Introductionmentioning

confidence: 99%

Current Guidelines for Dyspepsia Management

Ford

Martin

2008

Dig Dis

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Background: Dyspepsia is a global problem and the management of the condition remains a considerable burden on health care resources. Many countries have adopted evidence-based guidelines for the management of the condition, in an attempt to reduce health care expenditure. This article compares and contrasts dyspepsia management guidelines from several geographical regions. Methods: We obtained current guidelines from five regions and examined composition of guideline development groups, methodology involved, definition of dyspepsia utilized, and recommendations in terms of first-line approach, age cutoff for prompt upper gastrointestinal (GI) endoscopy, and subsequent role of endoscopy. Results: All guidelines carried out extensive reviews of the literature to inform their recommendations. The majority used a definition of dyspepsia in line with the Rome criteria. All agreed that alarm symptoms at any age warranted prompt endoscopy, and most recommended an age cutoff of between 50 and 55 years for endoscopy as an initial management strategy. In young patients without alarm symptoms, either ‘test and treat’ or empirical acid suppression were the initial management strategies of choice in all cases, with only one guideline recommending mandatory endoscopy in those whose symptoms failed to settle after this approach. Conclusions: Despite varying composition of guideline development groups and the different geographical regions, the recommendation of all the guidelines were remarkably similar, reflecting the quality of research conducted by the GI community as a whole.

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The Helicobacter pylori breath test: a surrogate marker for peptic ulcer disease in dyspeptic patients.

Cited by 83 publications

References 9 publications

Clinical practice - strategies for management of dyspepsia

Clinical practice - strategies for management of dyspepsia

Functional Gastroduodenal Disorders

Current Guidelines for Dyspepsia Management

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