Screening patients
with dyspepsia
to avoid unnecessary endoscopy
Canadian Medical Association Journal 1996; 154: 1533-1534
Source: Patel P, Khulusi S, Mendall MA et al: Prospective screening of dyspeptic patients by Helicobacter pylori serology. Lancet 1995; 346: 1315-1318
Researchers in England screened 183 patients with dyspepsia under age
45 for Helicobacter pylori infection, a history of sinister symptoms and regular use of nonsteroidal anti-
inflammatory drugs to determine what proportion of diagnostic endoscopies could safely be avoided by this manoeuvre. Endoscopy in the 113 patients (62%) who were screen-positive revealed peptic ulceration in 34 (19%, n = 183). The 70 patients (38%) who were screen-negative received symptomatic treatment. After 6 months no significant differences were found in severity of symptoms, level of patient reassurance, interference with life events and lost work days between this group and control patients who were screen-negative but underwent endoscopy. However, patients who did not have endoscopy used less medication and visited their physician less often. Three patients in
the study group who were screen-negative and were later referred for endoscopy obtained normal results. The screening program reduced the use of diagnostic endoscopy by 37%.
CMAJ May 15, 1996 (vol 154, no 10)