evolving approach to dyspepsia and nonulcer dyspepsia

BACKGROUND Previous studies have yielded conflicting results and substantial uncertainty about any independent association of Helicobacter pylori infection with dyspepsia, and about any benefits of antibiotic treatments for nonulcer or uninvestigated dyspepsia. OBJECTIVES To perform a systematic review of the literature to determine whether chronic infection with H pylori is relevant to nonul...

Volume 70, Number 1 www.aafp.org/afp American Family Physician 107 F amily physicians frequently encounter patients with dyspepsia. An organic cause, such as duodenal ulcer, is found in only about 40 percent of these patients.1 Hence, dyspepsia is considered to be functional, or idiopathic, in as many as 60 percent of patients (Table 1).2-4 The Rome II criteria provide an updated definition of ...

OBJECTIVES It has remained controversial how to manage patients who present with symptoms of dyspepsia. Should all dyspeptic patients undergo a radiological or endoscopic procedure to diagnose peptic ulcer, or would a serological test for Helicobacter pylori provide sufficient evidence to start all H. pylori-positive patients on empirical antibiotic therapy? METHODS The outcome of serological...

PURPOSE To assess the effect of eradication therapy for Helicobacter pylori on symptoms of nonulcer dyspepsia. DATA SOURCES Duplicate searches of bibliographic databases, reviews of proceedings of annual gastroenterology and H. pylori meetings from 1995 to 1999, reviews of reference lists, and contact with primary investigators and pharmaceutical manufacturers. STUDY SELECTION Included stud...

BACKGROUND Non-erosive reflux disease (NERD) is a variant of gastroesophageal reflux disease (GERD) in which patients with typical reflux symptoms have no evidence of erosive esophagitis at endoscopy. An objective diagnostic tool for NERD remains an unmet need for clinicians and researchers. This study was designed to determine the types of histological alterations seen in Nigerian patients wit...

OBJECTIVE To determine (a) the advantages and disadvantages of treatment options for the eradication of Helicobacter pylori and (b) whether eradication of H. pylori is indicated in patients with duodenal ulcer, nonucler dyspepsia and gastric cancer. DATA SOURCES A MEDLINE search for articles published in English between January 1983 and December 1992 with the use of MeSH terms Helicobacter py...

Nonulcer dyspepsia is a common clinical syndrome whose etiology is unknown. The sensitivity of the gastric mucosa to acid and duodenal contents in 18 patients with nonulcer dyspepsia was studied. The patients had a normal upper gastrointestinal endoscopy and biopsy specimens were obtained for determination of Helicobacter pylori status. Fifteen of the 18 patients were infected with H. pylori. A...

The prevalence of primary metronidazole resistance of Helicobacter pylori was studied in one Dutch hospital from 1993 to 1996 and in two additional Dutch hospitals in 1993 and 1996. All cultures of antral biopsy specimens yielding H. pylori in the study period were evaluated, except those from patients who had received anti-H. pylori treatment; 1,037 H. pylori strains, all from different patien...