P Bytzer

..In view of the rapidly changing epidemiology of Helicobacter pylori infection in the Western world the long-term effects of such a policy should be monitored closely...

..Novel agents have been tried, but with disappointing results. New drugs and administration forms have been reported but their efficacy needs confirmation...

..We analyzed data from this trial to quantify upper gastrointestinal nonbleeding adverse events (NB-UGI AEs)...

..It is well established, however, that troublesome upper gastrointestinal (GI) symptoms are commonly experienced among low-dose ASA users...

..We evaluated the diagnostic performance of the PPI test, in conjunction with other tests, for the diagnosis of GERD...

..Although most patients with gastro-oesophageal reflux disease (GERD) benefit from proton pump inhibitor (PPI) therapy, some experience only partial symptom relief...

..Lost productivity accounts for a significant part of the costs caused by gastrointestinal symptoms. We aimed to describe selfreported productivity in patients presenting with dyspepsia...

..Anxiety before colonoscopy may have adverse consequences and increase requirements for sedation and analgesics. We aimed to examine the effects of adding an information video to our usual preprocedural information...

..The mechanisms by which a drug causes dyspepsia are often unknown even though some drugs are known to cause direct mucosal injury. Non-steroidal anti-inflammatory drugs and antibiotics are common causes of drug-related dyspepsia...

..Here, the available data on the assessment of reflux symptoms--predominantly heartburn--in clinical trials of symptomatic reflux disease are examined...

..Compliance studies have shown that patients with reflux symptoms generally take their medication only when experiencing these symptoms...

..g. acid regurgitation, epigastric pain, dysphagia), effect on quality of life, patient satisfaction with treatment, and adverse events...

..In the near future, the empirical acid inhibition strategy will probably be cost-effective as gastro-oesophageal reflux becomes the predominant disorder in dyspeptic patients...

..A symptom-driven management approach will reduce long term drug intake in reflux patients. The proportion of H. pylori-negative ulcers has increased; helicobacter status must be assessed in all ulcer patients...

..These algorithms must specify the initial evaluation and treatment of candidates, and follow-up protocols for an on-demand strategy. Our group has developed such algorithms, which are presented here...

..Evaluating the therapeutic gain of cisapride is more difficult but meta-analyses indicate a somewhat larger effect...

..Most patients with dyspeptic symptoms are treated empirically. Drug-induced dyspepsia might therefore be reflected in the sequencing of prokinetics relative to other medications...

..First-dose acid suppression and symptom relief vary among PPIs; these differences require further investigation...

..This may be the reason for the general failure of acid suppression in clinical trials in these patients. It may be more rewarding to identify true responders to drug treatment by a single subject trial...

..Gastrointestinal symptoms in diabetic patients have also been linked to factors associated with long-standing disease and suboptimal control...

..The objectives of this study were to examine the characteristics for troublesome symptoms and to compare different ways of categorizing reflux symptoms as troublesome...

..0001) associated with poorer quality of life in diabetes, independent of age, gender, smoking, alcohol use, and type of diabetes. CONCLUSIONS: GI symptoms impact negatively on health-related quality of life in diabetes mellitus...

..Low socioeconomic class should be considered a risk factor for both upper and lower gastrointestinal symptoms...

..Single subject trials offer an alternative approach to identify and characterize responders to a specific treatment...

..CONCLUSIONS: Diabetes mellitus is associated with an increased prevalence of upper and lower gastrointestinal symptoms. This effect may be linked to poor glycemic control but not to duration of diabetes or type of treatment...

..pylori-negative patients, especially if treated empirically with eradication therapy. These results suggest that H. pylori infection should be assessed in all duodenal ulcer patients before treatment is decided...

..Lower doses of misoprostol are less effective and are still associated with diarrhea. Only misoprostol 800 micrograms/day has been directly shown to reduce the risk of ulcer complications...

..It is uncertain whether psychological distress is causally linked to symptoms, or whether GI symptoms per se increase levels of anxiety and depression...

..Patients' self-assessment of symptoms is central in drug treatment trials of functional dyspepsia. The validity of such ratings is important...

..In conclusion, there appears to be a subgroup of patients with functional dyspepsia who will respond to acid suppression over and above placebo, but further work is required to characterize these responders...

..Rebound acid hypersecretion (RAHS) has been demonstrated after 8 weeks of treatment with a proton-pump inhibitor (PPI). If RAHS induces acid-related symptoms, this might lead to PPI dependency and thus have important implications...

..8% were seen in our department. CONCLUSIONS: Decisions about acid suppressive therapy prescribing in hospital has little influence on prescribing in primary care...

..Response to proton pump inhibitor (PPI) treatment in dyspepsia is unpredictable...

..Further testing and validation are in progress...

..In non-responders, epigastric pain was expected not to be influenced by gastric acid stimulation or type of treatment...

..However, the prevention of erosive esophageal damage, strictures, and adenocarcinoma should be a goal of long-term treatment success, even in symptomatic GERD...

..Our aim was to determine the agreement between Rome II and Rome III subtypes, and to explore whether agreement depends on the symptom reporting method...

..In irritable bowel syndrome (IBS) subtyping is used in research and clinical practice. Knowledge of subtype stability is needed for proper design of trials and treatment strategies...

..We did a randomised trial to assess the efficacy and safety of a test-and-eradicate strategy compared with prompt endoscopy in the management of patients with dyspepsia...

..While the incidence of new treatments remains stable, the prevalence of long-term treatment is rising. Studies have shown that up to 70% of patients on chronic acid suppression lack a verified indication for treatment...

..Lack of symptom stability impairs the value of the random-starting-day trial and only patients with frequent and stable symptoms should be evaluated in this design...

..We aimed at investigating physicians' perceptions about GERD and lifestyle and at evaluating physician-patient agreement concerning the impact of GERD on the quality of life...

..It is possible that a subgroup of empirically treated patients redeem repeated prescriptions because of a positive response to therapy despite symptoms that are not acid related...

..This article reviews the possible reasons why patients are dissatisfied with the way their disease is managed...

..To study the hepatic transit time of an ultrasound contrast agent in patients with liver disease, and to evaluate the mechanism(s) of the well-established shorter cubital vein to hepatic vein transit time in cirrhosis...

..However, the lack of validation and reliability studies limits the value of the single subject trials presented so far...

..h) A 50% improvement in the primary efficacy end-point seems to be a reasonable definition of a responder...

..Endoscopic assessment is observer dependent and patient history may influence the interpretation of images. This study assessed the impact of knowledge bias in a large sample of endoscopists...

..Based on expert opinion and on data from observational studies, we suggest algorithms for the approach to acute and elective procedures based on procedural risk and on risks for thromboembolic episodes...

..On-demand therapy should not be considered for patients with severe esophagitis...

..Helicobacter pylori testing is still recommendable owing to the long-term benefits, but the rapidly decreasing Helicobacter prevalence will soon make the test-and-treat strategy cost-ineffective as the initial step...

..The aim of this study was to create models estimating the BO population fitting each of these three hypotheses, in order to select the most plausible hypothesis and to gain insight into the Danish BO population...

..To evaluate the costs and effectiveness of on-demand maintenance therapy with oral esomeprazole, lansoprazole, omeprazole, pantoprazole or rabeprazole in patients with endoscopy-confirmed non-erosive reflux disease (NERD) in the UK...

..12) and Upper GI/Dysmotility cluster (OR = 10.12) when used in combination with insulin. CONCLUSION: Diabetes can be grouped according to common GI symptoms. Glycemic control and treatment for DM predict membership of symptom clusters...

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