Utilization and outcomes of office-based testing for Helicobacter pylori (HP) in symptomatic primary care patients

Patients with dyspepsia benefit from eradication of helicobacter pylori if other organic causes for dyspepsia were carefully ruled out

“…In contrast, the first longterm observation study showed a clear benefit for dyspeptic patients whose HP-infection was cured compared to those with persistent infection (1). This benefit was also observed in some other longterm studies published thereafter (8-11), but very recently other studies concluded that there was no advantage to eradication therapy (12)(13)(14)(15). However, inclusion of HP-positive patients with additional diseases potentially causing dyspeptic symptoms may have hampered the exploration of the role of HP in the etiology of dyspepsia.…”

“…Pa t i e n ten: 2 01 Pa t i e n ten mit mindestens sechs Monate andaue rnden dypspept i s chen Symptomen ste l l ten sich in unserer End o s kopie vo r. Pa t i e n ten mit einer Ulkusanamnese wurden ausge s ch l o s s e n . M e thoden: Na ch Durch f ü h rung einer Gast ro s kopie und des 13 C-H a m sto ff -Ate m te stes wurden Pa t i e n ten mit Ulkus, axialer G l e i th e rnie, Ösophagitis und nega t i vem HP-Status ausge s ch l o ssen. Um andere orga n i s che Urs a chen der Dyspepsie zu erfa s s e n , w u rden bei den verbliebenen Pa t i e n ten eine Ab d o m e n s o n o graphie, ein H 2 -E x h a l a t i o n ste st mit Laktose sowie eine 24-h -p H-M et rie des Ösophagus durch ge f ü h rt.…”

“…Bei 20 Pa t i e n ten wurde die H P-l n fektion als Urs a che der dys p e pt i s chen Besch we rden ange n o mmen. Der Era d i ka t i o n s e rfolg wurde sechs Wo chen und sechs Monate n a ch Therapie durch den 13 C-H a rn sto ff -Ate m te st ko n t ro l l i e rt sowie die d ys p e pt i s chen Besch we rden anhand eines va l i d i e rten Sympto m s c o re s e rh o b e n . E rgebnisse: Von 20 Pa t i e n ten mit HP-G a st ritis und Dypspepsie war bei 13 Pa t i e n ten die Therapie erfo l gre i ch, sieben Pa t i e n ten ve r b l i e b e n H P-p o s i t i v. Sechs Monate nach Therapie wa ren die Symptome der erfo l gre i ch behandelten Pa t i e n ten signifi kant ge b e s s e rt (Score 17,4 ± 1, 5 und 10,2 ± 0,8, p < 0,01).…”

Detection of Helicobacter Pylori by PCR on Gastric Biopsy Specimens Taken for CP Test: Comparison with Histopathological Analysis

“…However, the increased detection of antibiotic-resistant strains of H. pylori (10), added to the evidence that the failure in eradication of infection is associated to a greater incidence of secondary resistances (II ),justifies the importance ofroutine pre-treatment susceptibility testing. Although the application of this "test and treat" strategy is founded on economic analyses, because it results in a significant reduction ofendoscopic workload, recent studies showed that this approach is not necessarily associated with a cost benefit (12,13).…”

The cost of diagnosing Helicobacter pylori infection

“…In contrast to these studies is a recent study in primary care in the USA, which suggested that H. pylori test and treat strategies did not lead to fewer referrals to gastroenterologists, or fewer endoscopies in dyspeptic patients presenting to primary care physicians. The latter study suggested that the economic benefits suggested by computer models might not be achieved in practice 7 …”