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A Journal on Internal Medicine

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Minerva Medica 2008 June;99(3):323-33

language: English

Gastritis, dyspepsia and peptic ulcer disease

Dore M. P. 1, Graham D. Y. 2

1 Medical Clinic Institute University of Sassari, Sassari, Italy
2 Departments of Medicine Michael E. DeBakey VAMC and Baylor College of Medicine, Houston, TX, USA


Peptic ulcer disease remains a common problem and it most frequently due to the presence of an Helicobacter pylori infection or use of non-steroidal anti-inflammatory drugs (NSAIDs). Dyspepsia is neither sensitive or specific for diagnosing peptic ulcer disease. The approach to patients with dyspepsia is to arrive at a definitive diagnosis without unnecessary exposure to invasive or costly diagnostic procedures. Non-invasive testing is preferred with endoscopy being reserved for those with alarm markers or above a specified age (e.g., 55 years in Western countries). Patients negative for H. pylori infection should receive an empiric trial of acid suppression for 4 to 8 weeks and if beneficial it can be continued.

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