The optimal approach for management of patients with dyspepsia has not been determined.
Dr Dorte Ejg Jarbol and colleagues from Denmark compared the efficacy of the management of dyspepsia.
The team assessed empirical antisecretory therapy, testing for Helicobacter pylori, or a combination of the strategies.
The research team observed cluster-randomized trial in general practices.
Initial treatment with proton pump inhibitor (PPI) was performed in 222 patients.
| The mean use of endoscopies per patient after 1 year was higher in the PPI group|
|American Journal of Gastroenterology|
H pylori test-and-eradication was undertaken in 250 patients.
Proton pump inhibitors followed by H pylori-testing if symptoms improved were given to 250 patients.
Symptoms, quality of life, patient satisfaction, and use of resources were recorded during a 1-year follow-up.
The researchers found that the prevalence of H pylori infection was 24%.
The team found no difference among the 3 strategies in terms of the proportion of days without dyspeptic symptoms.
After 1 year, gastrointestinal symptom scores and quality-of-life scores had improved significantly and equally in the 3 groups.
The researchers observed no statistically significant differences among the groups.
The mean use of endoscopies per patient after 1 year was higher in the proton pump inhibitor group than in the other 2 groups.
H pylori-positive patients given eradication therapy had more days without dyspeptic symptoms.
The team noted that patients given the eradication therapy used less antisecretory therapy, and were more satisfied than H pylori-negative patients.
Dr Jarbol's team concluded, “The strategies based on H pylori test enjoyed similar symptom resolution.”