Commentary
See article on page 186Helicobacter pylori and dyspepsia: trick or treat?
| The first 150 words of the full text of this article appear below. |
Clinicians working in both primary and secondary care still do not have evidence-based guidance on the management of dyspepsia which is both clinically effective and cost-efficient. Perhaps we never will. Moving therapeutic targets often generate questions faster than researchers can answer them. Nevertheless, we do need better information about the inter-relations between dyspepsia, Helicobacter pylori infection, H pylori eradication, and endoscopy. The paper by Heaney et al (see page 186) provides a good deal of information, but also raises further questions about alternative strategies for managing dyspepsia.
The background is familiar. Until H
pylori burst on to the scene, there was some controversy about
empirical therapy versus early endoscopy in the initial management of
dyspepsia, but the availability of accurate diagnostic and effective
therapeutic methods in H pylori management
means that clinicians can now choose from two further strategies
(1)
test and endoscope and (2) test and treat. In
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Relevant Article
- A prospective randomised trial of a "test and treat" policy versus endoscopy based management in young Helicobacter pylori positive patients with ulcer-like dyspepsia, referred to a hospital clinic
- A Heaney, J S A Collins, R G P Watson, R J McFarland, K B Bamford, and T C K Tham
Gut 1999 45: 186-190.[Abstract] [Full Text] [PDF]
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