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Article: Empirical treatment based on "typical" reflux symptoms is inappropriate in a population with a high prevalence of Helicobacter pylori infection

TitleEmpirical treatment based on "typical" reflux symptoms is inappropriate in a population with a high prevalence of Helicobacter pylori infection
Authors
Issue Date2002
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
Citation
Gastrointestinal Endoscopy, 2002, v. 55 n. 4, p. 461-465 How to Cite?
AbstractBackground: Empirical therapy or early endoscopy have been recommended as acceptable management options for GERD. The objective of this study was to determine whether diagnosis and empirical treatment based on reflux symptoms alone are appropriate as initial management for patients with gastroesophageal reflux. Method: Consecutive patients presenting with weekly reflux symptoms were evaluated with a structured questionnaire followed by endoscopy. Patients with dyspepsia as the predominant symptom, "alarm" symptoms (weight loss, dysphagia, or bleeding), history of peptic ulcer or gastric surgery, or recent nonsteroidal anti-inflammatory drugs intake were excluded. Results: Four hundred sixty patients were studied: 82 (18%) were found to have peptic ulcer disease and 78 (95%) were infected with Helicobacter pylori. Concomitant erosive esophagitis was found in 26 (32%) of these patients with peptic ulcer disease. In the remaining 378 patients, 218 (58%) had erosive esophagitis and 1 had esophageal cancer. Among the 159 patients with no endoscopic lesion, 148 (93%) had relief of symptoms when treated with a proton pump inhibitor. Multivariate analysis showed that male gender (OR: 1.8, p = 0.03), age greater than 60 years (OR: 2.2, p = 0.01) and H pylori infection (OR: 3.6, p = 0.008) were significantly associated with a diagnosis of peptic ulcer disease. Coexisting dyspeptic symptom was not a predictor (p = 0.13) for peptic ulcer disease. Conclusions: In populations with a high prevalence of H pylori infection, a significant proportion of patients with GERD have concomitant peptic ulcer disease. Empirical treatment based on "typical" GERD symptoms alone may not be appropriate. Copyright © 2002 by the American Society for Gastrointestinal Endoscopy.
Persistent Identifierhttp://hdl.handle.net/10722/162618
ISSN
2015 Impact Factor: 6.217
2015 SCImago Journal Rankings: 2.390
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorWu, JCYen_US
dc.contributor.authorChan, FKLen_US
dc.contributor.authorChing, JYLen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorLee, YTen_US
dc.contributor.authorSung, JJYen_US
dc.date.accessioned2012-09-05T05:21:43Z-
dc.date.available2012-09-05T05:21:43Z-
dc.date.issued2002en_US
dc.identifier.citationGastrointestinal Endoscopy, 2002, v. 55 n. 4, p. 461-465en_US
dc.identifier.issn0016-5107en_US
dc.identifier.urihttp://hdl.handle.net/10722/162618-
dc.description.abstractBackground: Empirical therapy or early endoscopy have been recommended as acceptable management options for GERD. The objective of this study was to determine whether diagnosis and empirical treatment based on reflux symptoms alone are appropriate as initial management for patients with gastroesophageal reflux. Method: Consecutive patients presenting with weekly reflux symptoms were evaluated with a structured questionnaire followed by endoscopy. Patients with dyspepsia as the predominant symptom, "alarm" symptoms (weight loss, dysphagia, or bleeding), history of peptic ulcer or gastric surgery, or recent nonsteroidal anti-inflammatory drugs intake were excluded. Results: Four hundred sixty patients were studied: 82 (18%) were found to have peptic ulcer disease and 78 (95%) were infected with Helicobacter pylori. Concomitant erosive esophagitis was found in 26 (32%) of these patients with peptic ulcer disease. In the remaining 378 patients, 218 (58%) had erosive esophagitis and 1 had esophageal cancer. Among the 159 patients with no endoscopic lesion, 148 (93%) had relief of symptoms when treated with a proton pump inhibitor. Multivariate analysis showed that male gender (OR: 1.8, p = 0.03), age greater than 60 years (OR: 2.2, p = 0.01) and H pylori infection (OR: 3.6, p = 0.008) were significantly associated with a diagnosis of peptic ulcer disease. Coexisting dyspeptic symptom was not a predictor (p = 0.13) for peptic ulcer disease. Conclusions: In populations with a high prevalence of H pylori infection, a significant proportion of patients with GERD have concomitant peptic ulcer disease. Empirical treatment based on "typical" GERD symptoms alone may not be appropriate. Copyright © 2002 by the American Society for Gastrointestinal Endoscopy.en_US
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gieen_US
dc.relation.ispartofGastrointestinal Endoscopyen_US
dc.subject.meshAgeden_US
dc.subject.meshDyspepsia - Etiologyen_US
dc.subject.meshEsophagitis - Diagnosis - Microbiologyen_US
dc.subject.meshEsophagoscopyen_US
dc.subject.meshFemaleen_US
dc.subject.meshGastroesophageal Reflux - Diagnosis - Etiology - Therapyen_US
dc.subject.meshHelicobacter Infections - Complications - Therapyen_US
dc.subject.meshHelicobacter Pylorien_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPeptic Ulcer - Diagnosis - Microbiologyen_US
dc.subject.meshProspective Studiesen_US
dc.titleEmpirical treatment based on "typical" reflux symptoms is inappropriate in a population with a high prevalence of Helicobacter pylori infectionen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1067/mge.2002.122617en_US
dc.identifier.pmid11923754en_US
dc.identifier.scopuseid_2-s2.0-0036546943en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0036546943&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume55en_US
dc.identifier.issue4en_US
dc.identifier.spage461en_US
dc.identifier.epage465en_US
dc.identifier.isiWOS:000174921300001-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridWu, JCY=7409253910en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridChing, JYL=7005086238en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridLee, YT=8041471500en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US

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