Document Detail

Upper gastro-intestinal disease in Scotland: a survey of practice amongst Scottish gastroenterologists.
MedLine Citation:
PMID:  8908952     Owner:  NLM     Status:  MEDLINE    
Given the range of causes of upper gastrointestinal disease (UGD), the evolving role of Helicobacter pylori in its pathogenesis and the variety of treatments available, one might expect complex management strategies in the management of these diseases. The aim of this study was to determine the current management strategies used in peptic ulcer disease and gastritis in Scotland and to identify areas where large and clinically important variations in practice exist between gastro-intestinal specialists. Between June and September 1994, 130 gastro-intestinal physicians and surgeons were sent a postal questionnaire based on their response to four hypothetical clinical scenarios. Eighty-one (63%) correspondents returned completed questionnaires. The case histories related to: bleeding duodenal ulcer; peptic ulceration whilst taking non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids; management of dyspepsia in the young; and management of gastritis. Thirty-eight per cent of clinicians surveyed advocated the use of intravenous acid reducing agents in peptic ulcer bleeding. A total of 88% advocated endoscopic therapy in the presence of stigmata of recent haemorrhage and 5% suggested a follow up of endoscopy to confirm healing after ulcer bleeding. In treating the patient with ulcer while on NSAIDs, 45% of clinicians would use H2 receptor antagonists, 37% would use omeprazole, 14% misoprostol and 4% helicobacter eradication. Of the clinicians surveyed, 63% said they would investigate a 25-year-old patient with dyspepsia by endoscopy and 84% of these will biopsy for H. pylori. Empirical treatment was favoured by 37% and 4% considered a barium meal. There was no consensus in the treatment of gastritis. There exists considerable divergence of opinion between clinicians in investigation and treatment of upper gastrointestinal disease. The role of endoscopy, the type and duration of medical treatment of bleeding and non bleeding ulcer and gastritis require further, more detailed investigation. A consensus document would be warmly welcomed.
A K Kubba; M R Whyman
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Royal College of Surgeons of Edinburgh     Volume:  41     ISSN:  0035-8835     ISO Abbreviation:  J R Coll Surg Edinb     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-12-13     Completed Date:  1996-12-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7503110     Medline TA:  J R Coll Surg Edinb     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  302-6     Citation Subset:  IM    
Department of General Surgery, St John's Hospital at Howden, Livingston, West Lothian, UK.
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MeSH Terms
Anti-Inflammatory Agents, Non-Steroidal / adverse effects
Dyspepsia / drug therapy*,  epidemiology
Gastritis / drug therapy*,  epidemiology
Helicobacter Infections / drug therapy*,  epidemiology
Helicobacter pylori*
Middle Aged
Peptic Ulcer / chemically induced,  drug therapy*,  epidemiology
Peptic Ulcer Hemorrhage / drug therapy,  epidemiology
Physician's Practice Patterns*
Scotland / epidemiology
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal

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