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Old 06-07-2012
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Default Workup for Peptil Ulcer Disease

Can anyone kindly tell me the ideal protocol for patient presenting first time with symptoms of Peptic ulcer disease like epigastric pain/discomfort, nausea vomitting. Provided age < 45 years and no alarm symptoms( weight loss, anaemia, haemetemesis, malena)

What will be the next best step???

Should we start empiric therapy with PPI/ H2 Blockers
or
Test for H. pylori first and then decide to give anti H.pylori regimen or not
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Old 06-07-2012
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Originally Posted by paul_87 View Post
Can anyone kindly tell me the ideal protocol for patient presenting first time with symptoms of Peptic ulcer disease like epigastric pain/discomfort, nausea vomitting. Provided age < 45 years and no alarm symptoms( weight loss, anaemia, haemetemesis, malena)

What will be the next best step???

Should we start empiric therapy with PPI/ H2 Blockers
or
Test for H. pylori first and then decide to give anti H.pylori regimen or not
If the pt is presenting with epigastric discomfort and is under 45 with no alarm Sx, then give a try with PPI and see if there is a response. If the pt doesn't respond, then proceed with endoscopy and H.pylori testing. If that is positive, treat for H.Pylori.

That is my understanding. Lets see what other think.
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