DO CLINICIAN ACCEPT THE ROLE OF HELICOBACTER-PYLORI IN DUODENAL-ULCERDISEASE - A SURVEY OF EUROPEAN GASTROENTEROLOGISTS AND GENERAL-PRACTITIONERS

Objectives, To examine to what extent clinicians in Europe accepted th e theory of the casual role of Helicobacter pylori (H. pylori) in duod enal ulcer disease in the year 1992, and to what extent the theory had influenced their diagnostic and therapeutic habits in the management of duodenal ulcer patients at that time. Design. Postal questionnaire. Setting. Three European countries: the UK, the Netherlands, and Denma rk. Subjects. Three hundred and three gastroenterologists, 250 general practitioners, 83 junior hospital doctors. Main outcome measures. Num ber of doctors believing H. pylori to be a significant cause of duoden al ulcer disease, use of diagnostic tests for detection of H. pylori a nd therapeutic regimens for eradicating H. pylori. Results. Four hundr ed and forty-two doctors replied. Eighty-four per cent of the British doctors, 73% of the Dutch doctors, and 47% of the Danish doctors accep ted the role of H. pylori in duodenal ulcer disease. The rates were hi gher among gastroenterologists than among general practitioners. Eight y-four per cent of the British doctors, 80% of the Dutch doctors, and 48% of the Danish doctors used diagnostic tests for H. pylori, most fr equently histological examination (64%). In patients with duodenal ulc er disease, H. pylori eradication was undertaken by 93% of the British doctors, 89% of the Dutch doctors, and 60% of the Danish doctors. A t riple therapy (a bismuth salt, metronidazole, and either amoxicillin o r tetracycline) was used by 57% (181/315) of the doctors. Conclusions. H. pylori treatment is frequently used in some countries. However, th e role of H. pylori in duodenal ulcer disease has not been accepted to the same extent in different European countries.