asmi
Forum Hero
Topics: 1043
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I think in here clinical markers means clinical features...
1. D.D of epigastric pain..R/O other causes...see its relation to food ,any regurgitation/heart burn/malena/hematemesis ..etc etc.
2.EGD to be done ..followed by serological test to confirm H.pylori infection.
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| daira
Forum Senior
Topics: 29
Posts: 138
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Lucky, I think in absence of any signs of GI bleeding, any suspicion for PUD should be checked with non-invasive tests for H Pylori, eg serology. If the serology is positive, a GI specialist referral is made for biopsy and hence confirmatory tests for Hpylori.
If there is no H pylori in initial serology, referral should be indicated still, as we have to rule out atrophic or autoimmune gastritis. So I think the first test to be done is Serology and further confirmatory tests by biopsy.
For practical purposes, for first-timers, I think careful history should be taken and appropriate Rx regimen should be selected. All cases with resistant or recurrent symptoms need a referral.
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| asmi
Forum Hero
Topics: 1043
Posts: 4,609
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Guest,
EGD and barium study to diagnose PUD..once it is diagnosed we need to go for serology/urea breath test to confirm H.pylori
As per kaplan
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| BellKicker
Forum Junior
Topics: 3
Posts: 49
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asmi,
I think you're right but looking at it as a PCP, the question is when to refer. You could do a trial of PPIs and do Helicobactor serology before referring, I guess.
Otherwise, you'd have to refer every case of epigastric pain.
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