H. pylori test-and-eradicate is as effective as endoscopy for management of dyspepsia

Research conducted by Dr Annmarie Lassen and colleagues in Denmark has found that screening for Helicobacter pylori is equally as safe and effective as prompt endoscopy for the management of dyspeptic patients.

The research, published in the August 5 issue of The Lancet, involved a randomized trial of 500 patients presenting with dyspepsia.

"If endoscopy access is restricted, H. pylori test-and-eradicate might be a safe and efficient alternative." Dr Annmarie Lassen

250 patients were given prompt endoscopy and the remaining 250 were assigned H. pylori test-and-eradicate.

447 patients completed 1-year follow-up.

Dr Lassen found no significant differences in symptoms between the two groups in the follow-up period. The median proportion of days without dyspeptic symptoms was 0.63 for the test-and-eradicate group, compared with 0.67 for the group given prompt endoscopy.

No significant differences in symptoms between the two groups.

The researchers found no differences between the groups in the number of sick-leave days taken, or subsequent visits to GPs or hospitals, in the follow-up period.

However, 12% of patients treated with test-and-eradicate were dissatisfied with their treatment compared with only 4% of patients treated with prompt endoscopy - a significant difference.

Dissatisfied patients: 12% test-and-treat, but 4% after endoscopy.

Dr Lassen is also aware that prompt endoscopy may be desirable in older patients, so that possible gastric cancer can be detected.