H.pylori infection diagnostic tests: Difference between revisions
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==Overview== | ==Overview== | ||
In developed countries, the use of test and treat strategy is declining for younger patients presenting with [[dyspepsia]]. In developing countries, as the rates of [[ulcer]] or [[gastric cancer]] are high, the more appropriate initial approach in the diagnosis of ''[[H. pylori]]'' infection in developing countries are an empirical test-and-treat approach or initial [[endoscopy]]. | |||
==Developed countries== | ==Developed countries== | ||
*The use of a test-and-treat strategy is declining for younger patients presenting with dyspepsia. | *The use of a test-and-treat strategy is declining for younger patients presenting with [[dyspepsia]]. | ||
*The preferred first line treatment when the H.pylori prevalence is <20% is the immediate use of an antisecretory drug (proton-pump inhibitor). | *The preferred first-line treatment when the ''[[H. pylori]]'' prevalence is <20% is the immediate use of an antisecretory drug ([[proton-pump inhibitor]]). | ||
*For those aged 50 and older, endoscopy to exclude an upper gastrointestinal malignancy and testing for H.pylori infection if no malignancy is found remains a logical approach. | *For those aged 50 and older, endoscopy to exclude an upper gastrointestinal [[malignancy]] and testing for ''[[H. pylori]]'' infection if no malignancy is found remains a logical approach. | ||
*Testing for | *Testing for ''[[H. pylori]]'' infection should be carried out in younger patients in countries with a high risk of [[gastric cancer]]. | ||
==Developing countries== | ==Developing countries== | ||
AS the rates of [[ulcer]] or [[gastric cancer]] are high, the more appropriate initial approach in diagnosis of ''[[H. pylori]] infection in developing countries are: | |||
*An empirical test-and-treat approach | *An empirical test-and-treat approach | ||
'''or''' | |||
*Initial endoscopy | *Initial [[endoscopy]] | ||
Latest revision as of 04:03, 24 January 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
In developed countries, the use of test and treat strategy is declining for younger patients presenting with dyspepsia. In developing countries, as the rates of ulcer or gastric cancer are high, the more appropriate initial approach in the diagnosis of H. pylori infection in developing countries are an empirical test-and-treat approach or initial endoscopy.
Developed countries
- The use of a test-and-treat strategy is declining for younger patients presenting with dyspepsia.
- The preferred first-line treatment when the H. pylori prevalence is <20% is the immediate use of an antisecretory drug (proton-pump inhibitor).
- For those aged 50 and older, endoscopy to exclude an upper gastrointestinal malignancy and testing for H. pylori infection if no malignancy is found remains a logical approach.
- Testing for H. pylori infection should be carried out in younger patients in countries with a high risk of gastric cancer.
Developing countries
AS the rates of ulcer or gastric cancer are high, the more appropriate initial approach in diagnosis of H. pylori infection in developing countries are:
- An empirical test-and-treat approach
or
- Initial endoscopy