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• W2088528979 abstract "<h3>Abstract</h3> <b>Objective</b> To compare the efficacy of a “<i>Helicobacter pylori</i> test and treat” strategy with that of an empirical trial of omeprazole in the non-endoscopic management by empirical prescribing of young patients with dyspepsia. <b>Design</b> Randomised controlled trial. <b>Setting</b> Hospital gastroenterology unit. <b>Participants</b> 219 patients under 45 years old presenting with dyspepsia without alarm symptoms. <b>Intervention</b> Patients received treatment with omeprazole 20 mg (group A) or with a urea breath test followed by an eradication treatment in case of <i>H pylori</i> infection or omeprazole alone in non-infected patients (group B). Lack of improvement or recurrence of symptoms prompted endoscopy. <b>Main outcome measures</b> Improvement in symptoms assessed by a dyspepsia severity score every two months; use of medical resources (endoscopic workload and medical consultation); clinical outcome. <b>Results</b> 96/109 (88%) patients in group A and 61/110 (55%) in group B (P < 0.0001) had endoscopy: in 19 patients in group A and 32 in group B (20/67 infected and 12/43 non-infected) because of no improvement; in 77 further patients in group A and 29 in group B (7 infected and 22 non-infected) because of recurrence of symptoms during follow up. Endoscopy showed peptic ulcers only in group A; oesophagitis occurred significantly more often in group B than in group A. About 80% of examinations were normal in both groups, but nine duodenal scars occurred in group A. <b>Conclusions</b> Eradication treatment allows resolution of symptoms in a large number of patients with dyspepsia and reduces the endoscopic workload. After a trial of omeprazole, symptoms recur in nearly every patient. Such treatment is also likely to mask an appreciable number of peptic ulcers and cases of oesophagitis." @default.
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• W2088528979 date "2003-05-22" @default.
• W2088528979 modified "2023-09-23" @default.
• W2088528979 title "Empirical prescribing for dyspepsia: randomised controlled trial of test and treat versus omeprazole treatment" @default.
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• W2088528979 doi "https://doi.org/10.1136/bmj.326.7399.1118" @default.
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