Breath
Test May Find Ulcer Bacterium
Excerpt By
Colette
Bouchez,
HealthScoutNews
(HealthScoutNews) -- If indigestion is your problem, a new study
may spell relief at the doctor's office: A simple breath test
that identifies the bacterium Helicobacter pylori may be
all you need to get to the bottom of that bloated feeling medically
known as dyspepsia.
That's the word from a new study appearing in tomorrow's British
Medical Journal. A group of Scottish researchers says that
testing for H. pylori -- the same organism found to cause
ulcers -- is as effective as a more invasive and uncomfortable
internal exam in determining if the bug is the source of the problem.
Not all doctors are so quick to applaud the research, however.
Renowned gastroenterologist Dr. Mark Pochapin says that H.
pylori's association with dyspepsia is considered somewhat
controversial.
"Essentially this study tells us that you may not have to do
an endoscopy in dyspepsia patients in order to find H. pylori.
But it's also important to remember that a definitive association
between H. pylori and dyspepsia has not been proven, so
in some ways the finding has limited relevance," says Pochapin,
a gastroenterologist at New York Weill Cornell Medical Center
in New York City.
"Showing that the bacteria is present in a condition where we
are not even certain it plays a role is, in my opinion, of limited
value," he says.
Dyspepsia, also known as chronic indigestion, affects the upper
abdomen, usually causing symptoms such as pain, bloating, nausea,
belching and a feeling of fullness with limited food intake. Though
it can be an annoying and even painful problem, in and of itself
it is rarely associated with any serious gastrointestinal disease.
Because there has been some speculation that dyspepsia may be
caused by H. pylori, the study group tried to find out
if it was possible to make a diagnosis using the same simple breath
test used for ulcer patients -- and if doing so would be as effective
as the more invasive endoscopy. This is a procedure that uses
a flexible tube with a light source inserted into the body, either
through the mouth or the anus, letting doctors see inside portions
of the stomach.
To test their theory, researchers from the University Department
of Medicine and Therapeutics at the Western Infirmary in Glasgow
gathered a study group of 708 patients, all of whom complained
of symptoms of dyspepsia, including repeated bouts of indigestion.
All of the patients had been referred to the hospital for an endoscopic
exam.
Researchers then divided the patients into two groups, with 356
receiving the breath test for H. pylori and 352 receiving
endoscopy as well as the breath test.
The researchers found the breath test for H. pylori was
as effective in diagnosing the presence of the bacterium as the
endoscopic exam. A 12-month follow-up assured the researchers
that no other, more serious problems were overlooked.
Not surprisingly, the patients also reported the breath test
was far easier to endure than the endoscopy -- and it was also
far less expensive.
The researchers concluded that breath testing -- and not endoscopy
-- should be the preferred method of testing dyspepsia patients
for H. pylori.
Pochapin, however, says it's important to note this finding applies
only to a specific group -- those with clearly defined indications
of dyspepsia without any other significant or alarming symptoms
that could indicate more serious disease.
And the researchers seem to agree. When what they call "sinister
symptoms" are present, they advise that more invasive testing
is essential.
This is an important distinction, Pochapin says, since some of
the patients in the study were found to have peptic ulcers --
a problem that can sometimes mimic the symptoms of dyspepsia and
would require endoscopy for a diagnosis to be made.
"It's imperative for people to understand that when symptoms
could suggest something more serious, good clinical judgment must
be used to determine whether or not endoscopy is necessary to
rule out more extensive and significant disease," Pochapin says.
The one comforting aspect of the study, he says, is that researchers
reported they did not miss any cancers even when non-invasive
testing was used.
What To Do: For more information on dyspepsia, visit the
Dyspepsia
File Center for Current Research. To learn more about H.
pylori, check out the Helicobacter
Foundation.
Reference
Source 101
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