A rational approach to uninvestigated dyspepsia in primary care: review of the literature.
In this paper the rationale and limitations of the four most important approach strategies to dyspepsia in primary care (empiric treatment, prompt endoscopy, "test-and-scope", and "test-and-treat") are analysed. It is concluded that in the absence of alarm symptoms, a "test-and-treat" approach is currently the most rational approach provided that three conditions are met: (1) a highly accurate test should be used, (2) the prevalence of Helicobacter pylori in the population should not be too low, and (3) an effective anti-H pylori regimen should be prescribed taking sufficient time to instruct and motivate the patient.
Arents
N L A
NL
Regional Public Health Laboratory, Groningen/Drenthe, The Netherlands.
Thijs
J C
JC
Kleibeuker
J H
JH
D003937:Diagnosis, Differential; D004415:Dyspepsia / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D016481:Helicobacter Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D016480:Helicobacter pylori; D006801:Humans; D011320:Primary Health Care / Q000379:methods