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Peptic Ulcer Disease Patients Should be Tested for H.Pylori before Treating the Infection

Patients with confirmed peptic ulcer disease should be tested for Helicobacter pylori infection rather than receiving treatment for the infection as a matter of course.

According to researchers in the United States, the practice of testing and treating H.pylori has steadily increased over the past 14 years.

They found the prevalence of H.pylori was only 36% which suggests "testing seems to be more appropriate than empiric treatment in patients with peptic ulcer disease."

In this study, 3,317 patients clinically diagnosed with peptic ulcers from 1984 through 1997 were identified by investigators at the Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.

Their review of a stratified random sample of 720 of these patients from the complete medical records of age, sex and calendar year found 298, 41%, had confirmed peptic ulcer disease.

Logistic regression was used to analyse changes in proportions of H. pylori testing, infection and treatment over time.

Of the 32% of the subjects with the disease who were tested for H.pylori , 36% were found to have the infection and 66% of these were given antibiotic therapy.

While the rate of testing for the infection increased from nil in 1984 to 96% in 1997, the prevalence remained the same, 36.4 versus 36.5%. An increase from nil to 95% was seen in the rate of treatment for those with H.pylori .

Calendar year was seen by logistic regression to be associated with H. pylori testing and treatment but not infection.

Fifty-eight percent of the subjects reported recent use of nonsteroidal anti-inflammatory drugs (NSAIDs) and GI bleeding was found in 44%.
Am J Gastroenterol 2002 Dec;97(12):3015-22. "Changing rates of Helicobacter pylori testing and treatment in patients with peptic ulcer disease."

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