{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T23:00:16Z","timestamp":1770505216363,"version":"3.49.0"},"reference-count":26,"publisher":"BMJ","issue":"7399","license":[{"start":{"date-parts":[[2003,5,22]],"date-time":"2003-05-22T00:00:00Z","timestamp":1053561600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2003,4,4]]},"published-print":{"date-parts":[[2003,5,24]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:bold>Objective<\/jats:bold>\n                    To compare the efficacy of a \u201c\n                    <jats:italic>Helicobacter pylori<\/jats:italic>\n                    test and treat\u201d strategy with that of an empirical trial of omeprazole in the non-endoscopic management by empirical prescribing of young patients with dyspepsia.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design<\/jats:bold>\n                    Randomised controlled trial.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting<\/jats:bold>\n                    Hospital gastroenterology unit.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Participants<\/jats:bold>\n                    219 patients under 45 years old presenting with dyspepsia without alarm symptoms.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Intervention<\/jats:bold>\n                    Patients received treatment with omeprazole 20 mg (group A) or with a urea breath test followed by an eradication treatment in case of\n                    <jats:italic>H pylori<\/jats:italic>\n                    infection or omeprazole alone in non-infected patients (group B). Lack of improvement or recurrence of symptoms prompted endoscopy.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Main outcome measures<\/jats:bold>\n                    Improvement in symptoms assessed by a dyspepsia severity score every two months; use of medical resources (endoscopic workload and medical consultation); clinical outcome.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results<\/jats:bold>\n                    96\/109 (88%) patients in group A and 61\/110 (55%) in group B (P &lt; 0.0001) had endoscopy: in 19 patients in group A and 32 in group B (20\/67 infected and 12\/43 non-infected) because of no improvement; in 77 further patients in group A and 29 in group B (7 infected and 22 non-infected) because of recurrence of symptoms during follow up. Endoscopy showed peptic ulcers only in group A; oesophagitis occurred significantly more often in group B than in group A. About 80% of examinations were normal in both groups, but nine duodenal scars occurred in group A.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions<\/jats:bold>\n                    Eradication treatment allows resolution of symptoms in a large number of patients with dyspepsia and reduces the endoscopic workload. After a trial of omeprazole, symptoms recur in nearly every patient. Such treatment is also likely to mask an appreciable number of peptic ulcers and cases of oesophagitis.\n                  <\/jats:p>","DOI":"10.1136\/bmj.326.7399.1118","type":"journal-article","created":{"date-parts":[[2003,5,22]],"date-time":"2003-05-22T18:33:53Z","timestamp":1053628433000},"page":"1118","source":"Crossref","is-referenced-by-count":49,"title":["Empirical prescribing for dyspepsia: randomised controlled trial of test and treat versus omeprazole treatment"],"prefix":"10.1136","volume":"326","author":[{"given":"Gianpiero","family":"Manes","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonella","family":"Menchise","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"de Nucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Balzano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2003,5,22]]},"reference":[{"key":"2025122211180370000_326.7399.1118.1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.7326\/0003-4819-102-2-266","article-title":"Endoscopy in the evaluation of dyspepsia.","volume":"102","year":"1985","journal-title":"Ann Intern Med"},{"key":"2025122211180370000_326.7399.1118.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)92023-0"},{"key":"2025122211180370000_326.7399.1118.3","doi-asserted-by":"publisher","DOI":"10.1136\/gut.41.1.8"},{"key":"2025122211180370000_326.7399.1118.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198602063140603"},{"key":"2025122211180370000_326.7399.1118.5","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.1997.00179.x"},{"key":"2025122211180370000_326.7399.1118.6","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-116-9-705"},{"key":"2025122211180370000_326.7399.1118.7","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1016\/S0140-6736(88)90929-4","article-title":"Prospective double-blind trial of duodenal ulcer relapse after eradication of Campylobacter pylori.","volume":"2","author":"Marshall","year":"1988","journal-title":"Lancet"},{"key":"2025122211180370000_326.7399.1118.8","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-123-4-199508150-00003"},{"key":"2025122211180370000_326.7399.1118.9","doi-asserted-by":"publisher","DOI":"10.1053\/gast.1996.v110.pm8536890"},{"key":"2025122211180370000_326.7399.1118.10","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-126-4-199702150-00004","article-title":"Management strategies for Helicobacter pylori seropositive patients with dyspepsia: clinical and economic consequences.","volume":"126","author":"Ofman","year":"1997","journal-title":"Ann Intern Med"},{"key":"2025122211180370000_326.7399.1118.11","first-page":"1773","article-title":"Cost-benefit analysis of testing for Helicobacter pylori in dyspeptic subjects.","volume":"91","author":"Sonnenberg","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"2025122211180370000_326.7399.1118.12","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/S1590-8658(01)80042-6","article-title":"High prevalence of reflux symptoms in duodenal ulcer patients who develop gastro-oesophageal reflux disease after curing Helicobacter pylori infection.","volume":"33","author":"Manes","year":"2001","journal-title":"Digest Liver Dis"},{"key":"2025122211180370000_326.7399.1118.13","unstructured":"Boyce HW . 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