Letters

Helicobacter gastroduodenitis

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7114.1015 (Published 18 October 1997) Cite this as: BMJ 1997;315:1015

Routine treatment will lead to extra workload

  1. Miles C Allison, Consultant gastroenterologista,
  2. David Williams, Consultant gastroenterologistb
  1. a Royal Gwent Hospital, Newport, South Wales NP9 2UB
  2. b Dr Gray's Hospital, Elgin, Morayshire IV30 1AJ
  3. c Centre for Cancer Research, University of Leeds, Cookridge Hospital, Leeds LS16 6QB
  4. d Centre for Digestive Diseases, General Infirmary at Leeds, Leeds LS1 3EX

    Editor—The editorial by Anthony Axon and David Forman contains many unwarranted assumptions.1 They suggest that doctors face ethical and perhaps legal difficulties if they fail to diagnose and treat Helicobacter pylori gastroduodenitis routinely in dyspeptic patients. This ignores the observation that H pylori gastroduodenitis is only slightly more common in people with dyspepsia than healthy volunteers2 and that only a minority of patients with non-ulcer dyspepsia derive symptomatic benefit from eradication of H pylori. For these reasons the British Society of Gastroenterology's dyspepsia management guidelines do not recommend eradication unless there is proved infection in association with erosive gastritis, peptic ulcer, or lymphoma.

    Axon and Forman estimate that H pylori infection causes 8000 deaths a year in England and Wales, most from gastric cancer. The relation between …

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