Editorial: Dyspepsia, Peptic Ulcer, and H. pylori: A Remembrance of Things Past

Vakil, Nimish
March 2010
American Journal of Gastroenterology;Mar2010, Vol. 105 Issue 3, p572
Academic Journal
Abstract: Dyspepsia and gastroesophageal reflux disease are common conditions in clinical practice. Current management strategies emphasize testing and treatment for Helicobacter pylori in the initial management of patients presenting with dyspeptic symptoms in regions where the prevalence of H. pylori infection is >15%. Population-based studies in patients with dyspepsia suggest that peptic ulcer disease related to H. pylori infection is decreasing in prevalence, whereas gastroesophageal reflux disease is becoming a more common cause of dyspeptic symptoms. Unfortunately, symptoms are a poor predictor of endoscopic findings, and alarm features are not a good predictor of an underlying malignancy. Although peptic ulcer disease has declined in Western countries, specific populations such as immigrants and rural communities may have a high prevalence of infection and peptic ulcer disease that needs to be considered in initial dyspepsia management, even in areas where the general prevalence of H. pylori infection has declined below 15%.


Related Articles

  • Esophagitis in a High H. pylori Prevalence Area: Severe Disease Is Rare but Concomitant Peptic Ulcer Is Frequent. Ponce, Julio; Calvet, Xavier; Gallach, Marta; Ponce, Marta // PLoS ONE;2011, Vol. 6 Issue 10, p1 

    Background: Few data are available on the prevalence of erosive and severe esophagitis in Western countries. Objective: To retrospectively determine the prevalence and the factors predicting erosive esophagitis and severe esophagitis in a large series of endoscopies in Spain. Design:...

  • Dyspepsia and peptic ulcers. Jamil, Khaleel; Forgacs, Ian // Update;Aug2007, Vol. 75 Issue 2, p13 

    The article focuses on the stomach disorders of dyspepsia and peptic ulcers. Dyspepsia refers to chronic or recurrent pain or discomfort centred in the upper abdomen. It mentions about referral guidelines for endoscopy and treatment of Helicobacter Pylori infection. Serology is, at best, a...

  • Increase of reflux esophagitis and decrease of peptic ulcer disease and Helicobacter pylori infection between 1994 and 2001. Sacca, N.; Rodino, S.; De Medici, A.; D'Amico, T.; Fragomeni, A.; Giglio, A. // Gut;Sep2002 Supplement 2, Vol. 51, pA36 

    In the past years the prevalence of of reflux esophagitis has been increasing, whereas the prevalence of ulcer peptic disease has been decreasing. In this study we analyzed, retrospectively, the patients who underwent endoscopy, in our Unit, in the years 1994-1997-2001. We studied clinical and...

  • Helicobacter pylori (HP) eradication does not cause esophagitis in healthy blood donors: 8 years follow-up. Ricci, C.; Vaira, D.; Rugge, M.; Russo, V.; Leandro, G.; Gatta, L.; Menegatti, M.; Tampieri, A; Miglioli, M.; Vakil, N. // Gut;Sep2002 Supplement 2, Vol. 51, pA42 

    Background: there is controversy about whether HP eradication causes erosive esophagitis but most studies have been limited by short follow-up and pre-existing ulcer disease. Aim: to determine the incidence of endoscopic esophagitis in asymptomatic blood donors who underwent eradication therapy...

  • Use of tobacco products and gastrointestinal morbidity: an endoscopic population-based study (the Kalixanda study). Aro, Pertti; Ronkainen, Jukka; Storskrubb, Tom; Vieth, Michael; Engstrand, Lars; Johansson, Sven-Erik; Bolling-Sternevald, Elisabeth; Bolinder, Gunilla; Alving, Kjell; Talley, Nicholas; Agréus, Lars // European Journal of Epidemiology;Oct2010, Vol. 25 Issue 10, p741 

    The impact of snus (smokeless tobacco or snuff) on gastrointestinal symptoms and pathological findings is largely unknown. The authors aimed to investigate whether the exposure to different forms of tobacco influences upper gastrointestinal symptoms, histology and frequency of Helicobacter...

  • Are there more clinically important complications of Helicobacter pylori infection than peptic ulcer disease? A review of current literature. Unge, Peter // Journal of Gastroenterology;1998 Supplement 10, Vol. 33, p48 

    Helicobacter pylori gastritis (i.e. H. pylori infection and complications) is a focus of tremendous research activity today. Besides peptic ulcer disease, a large number of reports suggest that other diseases are associated with H. pylori. The International Agency for Research on Cancer...

  • The Usefulness of the Likelihood Ratio in the Diagnosis of Dyspepsia and Gastroesophageal Reflux Disease. Moayyedi, Paul; Axon, A. T. R. // American Journal of Gastroenterology;Nov1999, Vol. 94 Issue 11, p3122 

    Clinicians are familiar with the concepts of sensitivity and specificity to describe the accuracy of a diagnostic test. These measures do not always express the probability that a patient has a disease with a given test result as this will vary with the prevalence of the disorder in the...

  • Dyspeptic Symptoms and Endoscopic Findings in the Community: The Loiano–Monghidoro Study. Zagari, Rocco Maurizio; Law, Graham Richard; Fuccio, Lorenzo; Pozzato, Paolo; Forman, David; Bazzoli, Franco // American Journal of Gastroenterology;Mar2010, Vol. 105 Issue 3, p565 

    OBJECTIVES:We aimed to evaluate the prevalence of endoscopic findings and their association with dyspeptic symptoms in the community.METHODS:A total of 1,533 inhabitants of two villages were invited to participate in a cross-sectional survey, and 1,033 were recruited. Participants underwent a...

  • Diagnosis of Helicobacter pylori in Britain. Duggan, Anne; Logan, Robert // Journal of Gastroenterology;1998 Supplement 10, Vol. 33, p31 

    The prevalence of Helicobacter pylori infection in the United Kingdom (UK) is similar to that of other developed Western countries with H. pylori infection a major cause of morbidity from peptic ulcer disease and gastric cancer. Guidelines for testing and treating H. pylori have been published...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics