DIAGNOSTIC-TESTS FOR HELICOBACTER-PYLORI - CAN THEY HELP SELECT PATIENTS FOR ENDOSCOPY

Aim. Dyspepsia is a common symptom and some selection process for endo scopy is required. This study seeks to determine if noninvasive tests for Helicobacter pylori could be useful as a screening test to help se lect patients for endoscopy. Methods, Consecutive patients attending f or upper gastrointestinal endoscopy were interviewed prior to endoscop y and the endoscopic diagnoses was recorded. The presence of Helicobac ter pylori infection was assessed by serology. Some patients also had a C-13 urea breath test or rapid urease test (CLO test). Results. 436 consecutive patients were evaluated. The endoscopy findings were norma l in 44%, 29% had reflux oesophagitis, 18% had duodenal ulcer, duodeni tis or gastric ulcer and 9% had other diagnoses. 54.8% of patients wer e positive for Helicobacter serology. Using either the CLO test or C-1 3 urea breath test as the confirmatory test for the diagnosis of Helic obacter pylori, the sensitivity of the serology test was 96% and 91% r espectively and the specificity was 66.6 and 82%. Patients with negati ve serology and no history of recent NSAID or aspirin use comprised 34 % of the total with dyspepsia or reflux symptoms. There were no gastri c or duodenal ulcers in this group. Conclusion, The serology test may have some potential for the initial evaluation of dyspepsia. These tes ts need to be prospectively evaluated in general practice.