SAN ANTONIO — Patients with gastroesophageal reflux disease (GERD) should undergo screening for Helicobacter pylori (HP) if they originate from endemic regions, according to study results presented at the American College of Gastroenterology (ACG) 2019 Annual Scientific Meeting from October 25 to 30, 2019 in San Antonio, Texas.
HP is highly prevalent in endemic regions and in US immigrants from these regions, however, current guidelines generally recommend screening for HP only in patients with active or prior peptic ulcer disease (PUD) and not in patients who exhibit only GERD symptoms. The objective of this study was to determine whether patients with GERD from endemic regions should undergo HP screening.
In this retrospective chart review, researchers evaluated patients with symptoms of GERD and/or PUD for whom orders were placed for HP screening after presenting with symptoms at an internal medicine ambulatory care clinic in 2017. Patients were stratified by symptoms of GERD, PUD, or both. All 122 patients who met selection criteria were further stratified by region of origin.
Results revealed that 43% of all patients (n=52) tested positive for HP, and that 92% of these patients came from an endemic region. Of those who tested positive for HP and came from endemic regions, 25% had GERD only, and 52% had both GERD and PUD symptoms. Of the 4 patients who had GERD and tested positive for HP who did not live in endemic areas, 1 patient had GERD only. Of all patients in this study who had GERD only, 25% tested positive for HP and were from endemic regions.
The main limitation of this study was that the sample size was small and skewed toward patients from specific endemic regions, and may not be applicable to endemic regions not evaluated in this study.
The study researchers concluded that recommendations for HP screening should also include patients who exhibit GERD symptoms only, irrespective of regional origin.
Ahmed A, Rotundo L, Silva A, Feurdean M, Atkin S. Exploring the possibility of gastroesophageal reflux disease as a screening factor for Helicobacter pylori in patients from endemic regions. Poster presented at: American College of Gastroenterology 2019 Annual Scientific Meeting; October 25-30, 2019; San Antonio, Texas. Abstract P1758.