The conceptual revolution concerning the role of Helicobacter pylori in the pathogenesis of peptic ulcer disease has raised the larger question of how to integrate this new information into the management of patients with dyspepsia.
The aim of this research was to critically evaluate current knowledge about dyspepsia and its management.
Relevant articles on dyspepsia were identified from MEDLINE searches and from the bibliographies of identified articles.
Studies that contained information on the prevalence of dyspepsia, endoscopic findings, and evaluations of alternative management strategies were reviewed.
By coupling H. pylori serological testing with clinical factors such as age and nonsteroidal antiinflammatory drug use, strategies have been developed that identify patients with organic disease.
Although the use of these strategies can reduce the volume of endoscopies, their effects on dyspepsia symptoms are unknown.
Computerized decision analysis models have been used to evaluate the cost-effectiveness of alternative strategies.
The indirect evidence obtained from these models suggests that empiric therapy, guided by H. pylori testing, may be the preferred approach.
However, the models have been hampered by the lack of information concerning dyspepsia symptoms, the primary health outcome of the majority of patients seen in primary practice settings.
Currently, the knowledge needed to integrate H. (...)
Mots-clés Pascal : Dyspepsie, Prévalence, Symptomatologie, Oesophagoscopie, Diagnostic, Evaluation, Traitement, Etiopathogénie, Relation incertitude, Bactériose, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bactérie, Etude critique, Revue bibliographique, Homme, Appareil digestif pathologie, Oesophage pathologie, Estomac pathologie, Endoscopie
Mots-clés Pascal anglais : Dyspepsia, Prevalence, Symptomatology, Esophagoscopy, Diagnosis, Evaluation, Treatment, Etiopathogenesis, Uncertainty relation, Bacteriosis, Infection, Helicobacter pylori, Spirillaceae, Spirillales, Bacteria, Critical study, Bibliographic review, Human, Digestive diseases, Esophageal disease, Gastric disease, Endoscopy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0345272
Code Inist : 002B13B03. Création : 27/11/1998.