Initial management strategies for dyspepsia

摘要: BACKGROUND: This review considers management strategies (combinations of initial investigation and empirical treatments) for dyspeptic patients. OBJECTIVES: To determine the effectiveness, acceptability, cost effectiveness following patients presenting with dyspepsia (a) pharmacological therapy (including endoscopy treatment failures) (b) early (c) testing Helicobacter pylori endoscope only those positive (d) H.pylori eradication or without prior testing. SEARCH STRATEGY: Trials were located through electronic searches extensive contact trialists. SELECTION CRITERIA: All randomised controlled trials in primary care. DATA COLLECTION AND ANALYSIS: Data was collected on symptoms, quality life use resources. MAIN RESULTS: Ten papers reporting 12 comparisons found. comparing proton pump inhibitors (PPI) antacids (2 trials) H2 receptor antagonists (3 trials), compared acid suppression pooled. PPIs significantly more effective than both H2RA s antacids. Relative risks (RR) 95% CI were, PPI: antacid 0.72 (0.64-0.80), 0.63 (0.47-0.85). Results other drug either absent inconclusive. Early not prescribing (RR 0.90 (0.77-1.04), but current studies lack power. No eligible test eradicate REVIEWER'S CONCLUSIONS: are these which may adequately exclude gastro-oesophageal reflux disease. The relative efficacy PPI is uncertain. benefit some dyspepsia. will be updated shortly several large that have recently been completed.