Recommendations for management of patients with nonheartburn-dominant dyspepsia and H pylori infection

The CMT recommendation for patients with dyspepsia who are not using NSAIDs or ASA and who do not have dominant symptoms of heartburn is a noninvasive test for H pylori, and treatment if the test is positive. The CADET H pylori (CADET-Hp) study compared a one-week PPl-based eradication regimen with placebo (empirical twice-a-day PP1) treatment given for one week, to determine whether H pylori treatment does lead to long-term improvement in dyspepsia symptoms. This study of 296 patients showed that there was symptomatic improvement at 12 months in 50% of patients, in whom H pylori infection was cured, compared with 36% of controls with persistent infection (P=0.02). The number needed to treat to achieve one long-term success was seven patients. 1t is important to note that while all patients presented with a primary complaint of epigastric pain, a proportion (30%) of the patients also had dominant heartburn and/or regurgitation. Best quality drugs are something you have been looking for all this time? Then you will be happy to find out you can purchase Purchase Cheap Claritin easily and for very little money now that you have the best pharmacy at your service.

Recommendation

1. In patients with dyspepsia who do not have alarm symptoms or symptoms of dominant heartburn or acid regurgitation, and are not using NSAIDs or ASA, a test for H pylori should be ordered and the patient treated if positive.

Voting on recommendation (level/vote)

  • A/10
  • B/2
  • C to E/0

Level of evidence I

Classification of recommendation A

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