Abstract
BackgroundOptimum management of dyspepsia in primary care is a debatable subject. Testing for Helicobacter pylori (HP) has been recommended in primary care as this strategy will cure most underlying peptic ulcer disease and prevent future gastro duodenal disease.MethodsA total of 98 patients completed Modified Glasgow Dyspepsia Severity Score Questionnaire (MGDSSQ) at initial presentation before undergoing the 13Carbon Urea Breath Test (UBT) for HP. Those with positive UBT received Eradication Therapy with oral Omeprazole 20 mg twice daily, Clarithromycin 500 mg daily and Amoxycillin 500 mg twice daily for one week followed by Omeprazole to be completed for another 4 to 6 weeks. Those with negative UBT received empirical treatment with oral Omeprazole 20 mg twice daily for 4 to 6 weeks. Patients were assessed again using the MGDSSQ at the completion of treatment and one month after stopping treatment.ResultsThe prevalence of dyspepsia at Universiti Kebangsaan Malaysia-Primary Care Centre was 1.12% (124/11037), out of which 23.5% (23/98) was due to HP. Post treatment assessment in both HP (95.7%, 22/23) and non HP-related dyspepsia (86.7%, 65/75) groups showed complete or almost complete resolution of dyspepsia. Only about 4.3% (1/23) in the HP related dyspepsia and 13.3% (10/75) in the non HP group required endoscopy.ConclusionThe prevalence of dyspepsia due to HP in this primary care centre was 23.5%. Detection of HP related dyspepsia yielded good treatment outcomes (95.7%).
Highlights
Optimum management of dyspepsia in primary care is a debatable subject
It is often difficult to distinguish between dyspepsia and Gastro-oesophageal reflux disease (GORD) in the uninvestigated patient who presents with upper gastrointestinal symptoms in primary care
This study aims to determine the prevalence of Helicobacter pylori (HP) related dyspepsia and treatment outcomes among patients attending the UKM Primary Care Centre, a university funded primary care clinic
Summary
Testing for Helicobacter pylori (HP) has been recommended in primary care as this strategy will cure most underlying peptic ulcer disease and prevent future gastro duodenal disease. One of the challenges in treating dyspepsia for primary care physicians is to determine the optimal treatment for the patient presenting with new onset or previously uninvestigated dyspeptic symptoms [3]. Dyspepsia could be due to several causes such as peptic ulcer disease, reflux disease, drugs (especially Non-Steroidal Anti-Inflammatory Drugs, NSAIDs) and idiopathic. Gastro-oesophageal reflux disease (GORD) presents with predominant or frequent (more than once a week) heartburn or acid regurgitation [4]. It is often difficult to distinguish between dyspepsia and GORD in the uninvestigated patient who presents with upper gastrointestinal symptoms in primary care
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