Differences in the Diagnostic Yield of Upper Gastrointestinal Endoscopy in Dyspeptic Patients Receiving Proton-Pump Inhibitors and H2-Receptor Antagonists

Mitchell, R. M.; Collins, J. S. A.; Watson, R. G. P.; Tham, Tck

doi:10.1055/s-2002-33230

Cited by 12 publications

(4 citation statements)

References 5 publications

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“…A detailed review of the published literature (4–7,17–61) was conducted to identify studies on dyspepsia in children (evaluating the efficacy, safety, side effects, and possible complications of UGI endoscopy) to provide the background for the panel process. The literature review considered a hierarchy of evidence‐based efficacy of medical procedures (9,57).…”

Section: Methodsmentioning

confidence: 99%

Indications to Upper Gastrointestinal Endoscopy in Children With Dyspepsia

Guariso¹,

Meneghel²,

Pozza³

et al. 2010

J. pediatr. gastroenterol. nutr.

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Section: Methodsmentioning

confidence: 99%

Indications to Upper Gastrointestinal Endoscopy in Children With Dyspepsia

Guariso¹,

Meneghel²,

Pozza³

et al. 2010

J. pediatr. gastroenterol. nutr.

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“…Endoscopy allows direct recognition of organic causes of dyspepsia such as peptic ulcer, erosive oesophagitis, or malignancy. 26 Abdominal ultrasonography can be used to rule out liver and pancreatico-biliary disease. In this study, upper GI endoscopy was done only in 45 patients.…”

Section: Discussionmentioning

confidence: 99%

Uses of Proton Pump Inhibitors and Their Prescribing Pattern among the Patients Attending the Out-Patient Department at a Tertiary Care Hospital in Bangladesh

Hasan¹,

Mondal²,

Parvin³

et al. 2020

J Enam Med Col

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Background: Proton pump inhibitors (PPIs) are one of the most frequently prescribed classes of drugs in the world in the treatment of peptic ulcer, dyspepsia and gastro-oesophageal reflux. Objectives: To determine demographic, clinical response and practice characteristics of PPIs among the patients attending the out-patient department of a tertiary care hospital. Materials and Methods: In this prospective observational study 100 patients attending the out-patient department and taking oral proton pump inhibitors (PPI) for different symptoms and duration were included. Patient’s socio-demographic characteristics, PPI-related information (duration, frequency of use, doses and classes of PPIs) and symptomatic responses after taking PPI were noted. Drugs or diseases that influenced the intake of PPI were also recorded. Investigations done before or during PPI use and their findings were also noted. Results: Omeprazole (43%) and esomeprazole (35%) were the most frequently prescribed PPIs. Most of the patients (52%) were on PPI therapy for 1−3 months. Majority of the patients (72%) had taken PPIs on daily basis and 19% patients had taken irregularly or occasionally. Dosing frequency of PPIs prescribed were twice daily in most of the patients (77%). Sixty seven percent (67%) patients had taken PPI prescribed by doctors and 33% patients had taken PPI prescribed by non-doctors. Common indications for prescribing PPIs were heart burn (54%), upper abdominal pain/discomfort (38%) and bloating (33%). Symptoms reappeared after stopping the PPI in most of the patients (40%) and 35% patients had satisfactory relief of symptoms with PPI. Conclusions: Omeprazole and esomeprazole are the most frequently prescribed PPIs. Majority of the patients had taken PPIs on daily basis. In around one-third of the patients PPIs were prescribed by non-doctors. Common indications for prescribing PPIs were heart burn, upper abdominal pain/discomfort and bloating. Symptomatic responses varied after taking PPI and symptoms reappeared after stopping the PPI in most of the patients. J Enam Med Col 2020; 10(1): 10-16

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“…One key issue when deciding whether or not to refer a patient for upper endoscopy is current use of antisecretory therapy. Many patients sent for endoscopy are taking prescription or over‐the‐counter PPI therapy currently 46–48 . This means that peptic ulcer disease, oesophagitis and even occasionally gastric cancers can be missed or masked; 46–48 this makes an early endoscopy strategy even less appealing.…”

Section: When To Consider Empirical Therapy In Your Practicementioning

confidence: 99%

What the physician needs to know for correct management of gastro‐oesophageal reflux disease and dyspepsia

Talley

2004

Aliment Pharmacol Ther

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Summary Upper gastrointestinal symptoms are highly prevalent; usually those consulting have multiple symptoms, confounding management. Here, common clinically relevant management issues are considered based on the best available evidence. Regardless of the presenting symptoms, determine if there are any alarm features; these have a low positive predictive value for malignancy but all patients with them should be referred for prompt upper gastrointestinal endoscopy. Ask about medications; of most importance are the non‐steroidal anti‐inflammatory drugs (NSAIDs), both non‐selective and COX‐2 selective. Try to ascertain if the symptom pattern suggests gastro‐oesophageal reflux disease (GERD) or not. Dominant heartburn, however, may be of limited value; if the background prevalence of GERD is 25% and the patient complains of dominant heartburn, then the likelihood that such a patient has GERD as identified by 24‐h oesophageal pH testing is only just over 50%. If reflux disease is strongly suspected and there are no alarm features, give an empirical trial of a proton pump inhibitor (PPI). Symptoms cannot separate adequately functional from organic dyspepsia. Endoscopy in dyspepsia with no alarm features is more costly than an empirical management approach. H. pylori testing and treatment remains in most settings the preferable initial choice for managing dyspepsia without obvious GERD. However, a PPI trial may offer a similar outcome and may be preferable in low H. pylori prevalence areas; head‐to‐head management trials in primary care are lacking.

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Differences in the Diagnostic Yield of Upper Gastrointestinal Endoscopy in Dyspeptic Patients Receiving Proton-Pump Inhibitors and H2-Receptor Antagonists

Abstract: The widespread use of acid suppression in the treatment of simple dyspepsia prior to endoscopy leads to a reduction in the endoscopic recognition of mucosal lesions caused by acid-peptic disease, but not to a high healing rate for these lesions, and it may mask malignancy.

Cited by 12 publications

References 5 publications

Indications to Upper Gastrointestinal Endoscopy in Children With Dyspepsia

Indications to Upper Gastrointestinal Endoscopy in Children With Dyspepsia

Uses of Proton Pump Inhibitors and Their Prescribing Pattern among the Patients Attending the Out-Patient Department at a Tertiary Care Hospital in Bangladesh

What the physician needs to know for correct management of gastro‐oesophageal reflux disease and dyspepsia

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