A survey of gastroenterologists' perceptions and practices related to Helicobacter pylori infection

OBJECTIVE: The aim of this study was to assess the current practice of gast roenterologists in the United States concerning Helicobacter pylori (H. pyl ori) infection. METHODS: We mailed a structured questionnaire to 1000 gastroenterologists c hosen at random from a national database. We asked about personal and pract ice demographics and practices relating to testing for, and treating, H. py lori infection. RESULTS: A total of 922 questionnaires were delivered, from which we receiv ed 286 responses (31%). Respondents used many different tests for H. pylori infection, but only 10% each had used either the C-13- Or C-14-urea breath test. Testing for II. pylori infection was usually for appropriate reasons , although 21% indicated that they might not treat a patient with a positiv e test result. Different multiple treatment regimens were used; the most fr equent were combinations of a proton pump inhibitor, clarithromycin, and ei ther amoxicillin or metronidazole. Estimates of the prevalence of antibioti c resistance were highly variable and often inaccurate. Most respondents wo uld not check asymptomatic individuals for the infection; however, in the a bsence of symptoms, 38% would personally undergo testing and treatment if p ositive. CONCLUSIONS: Gastroenterologists usually test for Ii. pylori infection in a ppropriate conditions, but may not always treat the infection based on a po sitive test result. Most use efficacious regimens to treat the infection al though many have inaccurate information on resistance rates, which may adve rsely influence prescribing. Many would have testing and, if positive, trea tment in the absence of symptoms or a specific diagnosis, but do not recomm end this for their patients. (C) 1999 by Am. Coil. of Gastroenterology.