Therapeutic Trial in Dyspepsia: Its Role in the Primary Care Setting

Nyrén, Olof

doi:10.3109/00365529109109538

Cited by 23 publications

(6 citation statements)

References 46 publications

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“…3 Medication use among dyspeptic patients is high. The majority uses over-the-counter drugs before consulting their general practitioner (GP) 4 and 70±90% receives pharmacotherapy, 1, 2, 5 mainly acid-inhibiting drugs, during their ®rst consultation. Although indications for maintenance therapy with acid-suppressing drugs are usually limited to chronic re¯ux complaints and oesophagitis, 6 estimates on the prevalence of long-term use vary from 2 to 5% of the population.…”

Section: Introductionmentioning

confidence: 99%

Helicobacter pylori treatment instead of maintenance therapy for peptic ulcer disease: the effectiveness of case‐finding in general practice

Wit

Quartero

Numans

1999

Aliment Pharmacol Ther

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Background: Maintenance therapy with acid‐inhibiting medication is common in general practice. Since the eradication of Helicobacter pylori has become the treatment of choice for peptic ulcer disease, H. pylori treatment could replace maintenance therapy in patients with an ulcer history.Aim: To determine the effectiveness of a full peptic ulcer disease history case‐finding strategy, together with subsequent H. pylori testing and treatment, in discontinuing maintenance therapy.Method: Patients were included from seven general practices, who had been using acid‐inhibiting medication for more than 3 months in the period May 1996–May 1997. Patients with a history of proven peptic ulcer disease were tested, and treated with proton pump inhibitor‐triple therapy if positive. Maintenance therapy was discontinued and restart within 12 months was monitored.Results: Long‐term acid suppression was used by 2.8% of the practice‐populations. A peptic ulcer disease history was found in 18% of the patients, 73% of whom were offered the ‘H. pylori test and treat’ alternative. The majority responded: 92% of the H. pylori‐infected patients were treated, 78% of whom successfully discontinued long‐term medication.Conclusion: Implementing an ‘H. pylori test and treat’ strategy enabled one‐third of the patients with a peptic ulcer disease history to stop maintenance therapy successfully. The strategy contributes to reduction of long‐term drug use, but compliance needs improvement.

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Section: Introductionmentioning

confidence: 99%

Helicobacter pylori treatment instead of maintenance therapy for peptic ulcer disease: the effectiveness of case‐finding in general practice

Wit

Quartero

Numans

1999

Aliment Pharmacol Ther

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“…The optimal initial evaluation and management of dyspepsia continues to be debated [59][60][61] . Options include: prompt endoscopy; empiric therapy with an antisecretory or a prokinetic agent, or a 'test-and-treat' strategy for Helicobacter pylori [62] .…”

Section: Dyspepsiamentioning

confidence: 99%

Gastrointestinal Motility Disorders: An Update

Lacy

Weiser

2006

Dig Dis

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Gastrointestinal motility disorders encompass a wide array of signs and symptoms that can occur anywhere throughout the luminal gastrointestinal tract. Motility disorders are often chronic in nature and dramatically affect patients’ quality of life. These prevalent disorders cause a tremendous impact both to the individual patient and to society as a whole. Significant progress has been made over the last 5 years in understanding the etiology and pathophysiology of gastrointestinal motility disorders. This clinical update will focus on seven of the most common gastrointestinal motility disorders (achalasia, non-achalasia esophageal motility disorders, dyspepsia, gastroparesis, chronic intestinal pseudo-obstruction, irritable bowel syndrome, and chronic constipation) with an emphasis on current treatment options and new therapeutic modalities.

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“…Investigations such as those of Mann et al , 7 Davenport et al 9 and Talley and Piper 10 have allowed a clear separation of patients into high‐ and low‐risk categories based wholly on the presenting symptom pattern. The decision on whether the patient requires only reassurance, whether a therapeutic trial 18 is appropriate, or whether further investigation is called for immediately, can be made on this basis with a considerable degree of confidence. A study in Leicester by Williams et al concluded that ‘young patients with simple dyspepsia are overinvestigated.…”

Section: Discussionmentioning

confidence: 99%