A “test for Helicobacter pylori and treat” strategy is more effective than treatment with a proton pump inhibitor for managing dyspepsia in young patients. In a randomised controlled trial in patients aged under 45 with uninvestigated symptoms of dyspepsia, Manes and colleagues (p 1118) compared empirical treatment with omeprazole with test and treat (urea breath test for H pylori followed by eradication treatment if necessary or by omeprazole alone). With the test and treat strategy, symptoms resolved in many patients and the need for endoscopy was reduced, whereas symptoms usually recurred after a trial of omeprazole. The authors conclude that test and treat should be the preferred option if empirical treatment of dyspepsia is to be performed.
Figure 1.
