Low yield of endoscopy in patients with persistent dyspepsia taking proton pump inhibitors

Background: Options for the evaluation of dyspepsia include a Helicobacter pylori test-and-treat strategy, empiric acid suppression, and initial endoscopy. The aim of this study was to determine the yield of endoscopy in patients in whom empiric therapy is unsuccessful compared with patients who rec...

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Bibliographic Details
Published in:Gastrointestinal endoscopy 2003-07, Vol.58 (1), p.9-13
Main Authors: Smith, Terrence, Verzola, Edwardo, Mertz, Howard
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Case-Control Studies
Chi-Square Distribution
Digestive system. Abdomen
Dyspepsia - diagnosis
Dyspepsia - drug therapy
Endoscopy
Female
Follow-Up Studies
Gastric Mucosa - drug effects
Gastric Mucosa - pathology
Gastrointestinal Agents - therapeutic use
Gastroscopy
Helicobacter Infections - diagnosis
Helicobacter Infections - drug therapy
Helicobacter pylori - isolation & purification
Histamine H2 Antagonists - therapeutic use
Humans
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical sciences
Middle Aged
Pain Measurement
Probability
Proton Pump Inhibitors
Proton Pumps - therapeutic use
Reference Values
Sensitivity and Specificity
Severity of Illness Index
Surveys and Questionnaires
Treatment Outcome
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Summary:Background: Options for the evaluation of dyspepsia include a Helicobacter pylori test-and-treat strategy, empiric acid suppression, and initial endoscopy. The aim of this study was to determine the yield of endoscopy in patients in whom empiric therapy is unsuccessful compared with patients who received no empiric therapy and to identify factors associated with endoscopic findings. Methods: A total of 100 patients with dyspepsia referred for endoscopy completed a questionnaire that included a query concerning response to therapy. EGD findings were compared in patients taking an H2-receptor antagonist, patients taking a proton pump inhibitor, and those not receiving empiric therapy. Results: There were fewer endoscopic findings in patients being treated with a proton pump inhibitor compared with those taking an H2-receptor antagonist or those not receiving therapy (p < 0.01). Fewer proton pump inhibitor recipients had esophagitis or ulcer compared with patients in the no therapy group. Lack of symptom relief (
ISSN:0016-5107
1097-6779
DOI:10.1067/mge.2003.308