The role of screening for Helicobacter pylori in patients with duodenal ulceration in the primary health care setting.

摘要: BACKGROUND: It is known that at least 90% of duodenal ulcers are caused by infection with the bacterium Helicobacter pylori. Eradicating this organism usually results in complete resolution disease. Testing for H pylori was introduced relatively recently, and thus, many patients to have uncomplicated peptic ulcer disease who continue need long-term treatment ulcer-healing drugs never been tested or offered eradication therapy. In modern computerized practices, subgroup can readily be identified reference morbidity repeat prescribing data. Eradication group has great potential benefit individuals concerned as well cost-saving National Health Service. AIM: The aim prospective study determine whether it worthwhile screening treating a general practice population previously diagnosed taking long term. METHOD: 1994, 7100 patients, data were used identify 40 (0.6%) proven medication term uncertain status. Twenty-nine subjects agreed undergo serology testing antibodies. Of 20 (69%) positive, 18 (eight women, median age 63.8 years) given Seventeen received omeprazole mg once daily amoxycillin 500 three times 14 days metronidazole 400 first 7 days; remaining patient inadvertently omitted. [13C]Urea breath carried out local hospital one month after therapy had successful. Subjects also personally followed up telephone 1 4 months assess success subjectively. RESULTS: showed successful all 17 (100%) intended regimen. not eradicated only amoxycillin. Four eradication, 13 (76%) remained completely asymptomatic. Two four some recurrent dyspepsia gastro-oesophageal reflux their ongoing symptoms seemed, on close questioning, more attributable than CONCLUSION: those previous ulceration medication. high rate achieved regimen compares very favourably other regimens. However, there may coexisting pathology, does necessarily result disappearance dyspeptic symptoms. Thus, when monitoring outcome important improvement objective evidence eradication.