Recognizing peptic ulcer disease

Keys to clinical and laboratory diagnosis

David Y. Graham Dr Graham is professor of medicine and molecular virology and chief, digestive disease division, department of medicine, and Dr Rakel is professor, department of family and community medicine, Baylor College of Medicine, Houston. Dr Graham is also on staff of the gastroenterology section, Veterans Affairs Medical Center, Houston.Correspondence[email protected]

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Robert E. Rakel Dr Graham is professor of medicine and molecular virology and chief, digestive disease division, department of medicine, and Dr Rakel is professor, department of family and community medicine, Baylor College of Medicine, Houston. Dr Graham is also on staff of the gastroenterology section, Veterans Affairs Medical Center, Houston.

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A. Mark Fendrick Dr Fendrick is assistant professor, department of internal medicine, University of Michigan Medical School, and assistant professor, department of health management and policy, University of Michigan School of Public Health, Ann Arbor.

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Mae F. Go Dr Go is assistant professor of medicine, digestive disease division, Baylor College of Medicine, and on staff of the gastroenterology section, Veterans Affairs Medical Center, Houston.

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Barry J. Marshall Dr Marshall is the Burnet Fellow, Helicobacter pylori research laboratory, University of Western Australia, Perth, and professor of research in internal medicine, independent research facility, University of Virginia School of Medicine, Charlottesville.

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David A. Peura Dr Peura is professor of medicine and associate chief, division of gastroenterology and hepatology, and director of clinical gastroenterology, Helicobacter pylori research laboratory, University of Virginia School of Medicine.

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Joseph E. Scherger Dr Scherger is professor and chairman, department of family medicine, University of California, Irvine, College of Medicine.

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PREVIEW

Determining which patients to test and which to treat is the crux of management of peptic ulcer disease. A number of laboratory tests are now available to confirm initial clinical recognition of dyspepsia due to Helicobacter pylori infection. Fortunately, the disease can be cured with combination antisecretory and antibiotic therapy. However, the value of testing in patients in whom the presence of an ulcer is unconfirmed remains controversial. Nevertheless, it is generally agreed that confirmed cases of H pylori infection should be treated. In this article, the authors discuss clinical and laboratory diagnosis of peptic ulcer disease and provide an algorithmic approach to evaluation.

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Recognizing peptic ulcer disease

Keys to clinical and laboratory diagnosis

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Keys to clinical and laboratory diagnosis

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