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Management of Helicobacter pylori ‐related gastrointestinal diseases by general practitioners in Italy
Author(s) -
Giovanni Maconi,
Cesare Tosetti,
Miroglio,
Parente,
Vittorio Colombo,
Sainaghi,
Bianchi Porro
Publication year - 1999
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.1999.00648.x
Subject(s) - medicine , helicobacter pylori , urea breath test , serology , referral , gastroenterology , disease , test (biology) , gerd , family medicine , helicobacter pylori infection , reflux , antibody , immunology , paleontology , biology
Aims : To investigate the diagnostic approach to and management of Helicobacter pylori infection at primary care level in Italy 2 years after the Maastricht consensus report. Methods : A total of 100 randomly selected general practitioners (GPs) answered a 12‐item multiple‐choice questionnaire, personally delivered and collected by non‐medical staff. Results : In 25% of cases, GPs preferred a prompt referral of dyspeptic patients to the specialist. The favourite diagnostic test for H. pylori infection was gastroscopy with biopsies (55%), followed by standard and office‐based serology (24% and 18%, respectively), and 13 C urea breath test (5%). H. pylori ‐eradication was prescribed in patients with peptic ulcer, reflux oesophagitis and functional dyspepsia by 64%, 43% and 66% of GPs, respectively. Only 7% of GPs adopted a test‐and‐treat approach. Proton pump inhibitor‐based triple therapies were used by almost all physicians. In peptic ulcer disease, most of GPs re‐tested patients in order to confirm H. pylori eradication (50% by gastroscopy with biopsies and 30% by serology only 2 months after therapy). Conclusions : Uncertainty seems to persist among Italian GPs concerning the indications for H. pylori treatment, the use of diagnostic tests, and patient follow‐up. In contrast, no doubts exist regarding the first choice eradication regimens. This survey suggests that further efforts should be made to spread scientific knowledge and guidelines on H. pylori diagnosis and management in primary care in Italy.