המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-13 12:00:13 EDT (Reuters Health)
LONDON (Reuters Health) – With the possible exception of a disease work-up in high-risk patients, Helicobacter pylori testing does not aid in the diagnosis of peptic ulcer disease in dyspeptic patients, according to a report published in the July 14th issue of the British Medical Journal.
Dr. Catherine F. Weijnen, from the University Medical Center Utrecht in the Netherlands, and colleagues performed a cross-sectional study of 565 patients who presented to their general practitioner with dyspeptic symptoms of at least 2 weeks duration.
The researcher found that a history of peptic ulcer disease, smoking, and pain on an empty stomach were strong independent predictors of a peptic ulcer disease diagnosis.
Based on these findings, a history of peptic ulcer disease was assigned a risk value of 2 and smoking and pain on an empty stomach were assigned a value of 1 each. High-risk patients were defined as having a score of 2 or greater, the authors explain.
In most patients, the addition of H. pylori testing to the patient's history added very little to the predictive value for peptic ulcer disease. However, in patients at high-risk for peptic ulcer disease, a positive H. pylori test increased the predictive value from 16% to 26%.
"In primary care, predicting the presence of peptic ulcer disease in dyspeptic patients on the basis of history taking is difficult," the researchers point out. However, the current findings indicate that "three simple questions from history taking can distinguish between patients at high and low risk of peptic ulcer disease."
"Adding testing for H. pylori infection to history taking might be useful only in patients at high risk of having peptic ulcer disease," the authors note. "It would avoid endoscopies in some patients and lead to more accurate treatment of peptic ulcer disease in most patients."
BMJ 2001;323:71-75.
-London Newsroom +44 20 7542 7986
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