O'Morain Colm
Trinity College Dublin, Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
World J Gastroenterol. 2006 May 7;12(17):2677-80. doi: 10.3748/wjg.v12.i17.2677.
The aetiology of dyspepsia is unknown in the majority of patients. Helicobacter pylori (H pylori) is the cause in a subset of patients. A non invasive test to assess the presence of H pylori is recommended in the management of patients under the age of 50 presenting to a family practitioner with dyspepsia. A urea breath test or a stool antigen test are the most reliable non invasive tests. Eradication of H pylori will reduce the risk to the patient with dyspepsia of developing a peptic ulcer, reduce the complication rate if prescribed non-steroid anti-inflammatory drugs and later reduce the risk of gastric cancer. The recommended treatment for non ulcer dyspepsia associated with a H pylori infection should be a 10-d course of treatment with a PPI and two antibiotics. Treatment efficacy should be assessed four weeks after completing treatment with a urea breath test or a stool antigen test.
大多数消化不良患者的病因不明。幽门螺杆菌(H pylori)是部分患者的病因。对于向家庭医生就诊的50岁以下消化不良患者,建议进行一项评估幽门螺杆菌存在情况的非侵入性检测。尿素呼气试验或粪便抗原检测是最可靠的非侵入性检测。根除幽门螺杆菌将降低消化不良患者发生消化性溃疡的风险,在开具非甾体抗炎药时降低并发症发生率,并在后期降低患胃癌的风险。与幽门螺杆菌感染相关的非溃疡性消化不良的推荐治疗方案应为使用质子泵抑制剂(PPI)和两种抗生素进行10天疗程的治疗。治疗结束四周后,应通过尿素呼气试验或粪便抗原检测评估治疗效果。