HELICOBACTER-PYLORI AND UPPER GASTROINTESTINAL-DISEASE - A SURVEY OF GASTROENTEROLOGISTS IN THE UNITED-KINGDOM

The objective of this study was to conduct a survey of the opinions an d practices of gastroenterologists in the United Kingdom concerning th e impact Helicobacter pylori infection management of upper gastrointes tinal diseases. A postal questionnaire was sent to all medically quali fied members of the British Society of Gastroenterology working in the UK. Replies were received from 670 of 1037 eligible BSG members (65%) . Of these, 73% thought that H pylori was a cause of duodenal ulcer an d 84% thought that eradication of H pylori decreased ulcer recurrence in comparison with acid suppression. While 80% used anti-tl pylori the rapy for a chronic relapsing duodenal ulcer, only 25% used such therap y for an ulcer at first presentation and 17% never used anti-H-pylori therapy for patients with duodenal ulcer. Although 75% of respondents did not agree that H pylori was a cause of non-ulcer dyspepsia, 69% us ed anti-H pylori therapy to treat a patient with this condition. At th e time of the survey, 69% of those who used anti-ti pylori therapy ado pted some variant of standard triple therapy. Only 7% routinely tested for bacterial sensitivity to antibiotics and only 22% assessed their patients for eradication after treatment. There was a lack of consensu s about whether H pylori was a cause of gastric ulcer or gastric cance r with only 47% and 17% respectively believing in these associations. In conclusion, at the time of the survey, the use of anti-H pylori the rapy had been accepted by a majority of specialist UK gastroenterologi sts in the management of upper gastrointestinal disease. There was, ho wever, a substantial degree of uncertainty and divergence about which patients should be treated.