Managing dyspepsia.
The prevalence of dyspepsia in the general population is as high as 40%, and its management represents a considerable financial burden to the health care system. Causes of dyspepsia amenable to medical therapy include peptic ulcer and functional dyspepsia, and testing for Helicobacter pylori and treating positive individuals is beneficial in both conditions. Individuals presenting for the first time with uninvestigated dyspepsia, age greater than 50 years, or alarm features require upper gastrointestinal (GI) endoscopy to exclude gastroesophageal malignancy. Upper GI endoscopy for younger individuals without alarm features is not cost-effective compared with the "test and treat" approach. Test and treat and empirical acid-suppression using a proton pump inhibitor (PPI) have similar costs and effects. Recent evidence suggests that empirical acid suppression commencing with antacids is as effective as PPI. Screening and treatment of H. pylori in PPI users and the community may reduce the costs of managing dyspepsia.
Ford
Alexander C
AC
Department of Academic Medicine, St. James's University Hospital, Leeds, LS9 7TF, UK. alexf12399@yahoo.com
Moayyedi
Paul
P
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D004415:Dyspepsia / Q000175:diagnosis* / Q000191:economics / Q000209:etiology / Q000628:therapy*; D016099:Endoscopy, Gastrointestinal; D016481:Helicobacter Infections / Q000150:complications / Q000188:drug therapy; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D010437:Peptic Ulcer / Q000150:complications / Q000188:drug therapy; D015995:Prevalence; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents; D054328:Proton Pump Inhibitors