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Noninvasive Helicobacter pylori testing was as effective as endoscopy for managing dyspepsia

Key Words: dyspepsia • Helicobacter pylori • breath tests • gastroscopy

The first 150 words of the full text of this article appear below.

Design
Randomised {allocation concealed^*}, unblinded,^* controlled trial with 1 year of follow up.

Setting
A gastroenterology clinic in Glasgow, UK.

Patients
708 patients (mean age 37 y, 53% men) who were referred by their general practitioners for investigation of upper gastrointestinal symptoms. Exclusion criteria were age >55 years, nonsteroidal anti-inflammatory drugs, or sinister symptoms. Follow up was 83%.

Intervention
Patients were allocated to endoscopy plus the noninvasive ¹⁴C-urea breath test (n=352) or the breath test alone (n=356) for determination of H pylori status. Patients were informed of their status after the test, and patients with positive results were prescribed a 7 day course of H pylori eradication treatment with omeprazole, 20 mg twice daily; clarithromycin, 250 mg 3 times daily; and amoxicillin, 500 mg (or metronidazole, 400 mg) 3 times daily.

Main outcome measures
Change from baseline on the Glasgow Dyspepsia Severity Score (GDSS). Secondary outcomes were use of medical resources, patient assessment of the . . . [Full text of this article]

Brendan Delaney, MD, FRCP, MRCGP

University of Birmingham
Birmingham, UK