FRIDAY, April 26, 2002 (HealthDayNews) -- If indigestion is your problem, a new study may spell relief at the doctor's office: A simple breath test that identifies the bacterium Helicobacter pylori may be all you need to get to the bottom of that bloated feeling medically known as dyspepsia.
That's the word from a new study appearing in tomorrow's British Medical Journal. A group of Scottish researchers says that testing for H. pylori -- the same organism found to cause ulcers -- is as effective as a more invasive and uncomfortable internal exam in determining if the bug is the source of the problem.
Not all doctors are so quick to applaud the research, however. Renowned gastroenterologist Dr. Mark Pochapin says that H. pylori's association with dyspepsia is considered somewhat controversial.
"Essentially this study tells us that you may not have to do an endoscopy in dyspepsia patients in order to find H. pylori. But it's also important to remember that a definitive association between H. pylori and dyspepsia has not been proven, so in some ways the finding has limited relevance," says Pochapin, a gastroenterologist at New York Weill Cornell Medical Center in New York City.
"Showing that the bacteria is present in a condition where we are not even certain it plays a role is, in my opinion, of limited value," he says.
Dyspepsia, also known as chronic indigestion, affects the upper abdomen, usually causing symptoms such as pain, bloating, nausea, belching and a feeling of fullness with limited food intake. Though it can be an annoying and even painful problem, in and of itself it is rarely associated with any serious gastrointestinal disease.
Because there has been some speculation that dyspepsia may be caused by H. pylori, the study group tried to find out if it was possible to make a diagnosis using the same simple breath test used for ulcer patients -- and if doing so would be as effective as the more invasive endoscopy. This is a procedure that uses a flexible tube with a light source inserted into the body, either through the mouth or the anus, letting doctors see inside portions of the stomach.
To test their theory, researchers from the University Department of Medicine and Therapeutics at the Western Infirmary in Glasgow gathered a study group of 708 patients, all of whom complained of symptoms of dyspepsia, including repeated bouts of indigestion. All of the patients had been referred to the hospital for an endoscopic exam.
Researchers then divided the patients into two groups, with 356 receiving the breath test for H. pylori and 352 receiving endoscopy as well as the breath test.
The researchers found the breath test for H. pylori was as effective in diagnosing the presence of the bacterium as the endoscopic exam. A 12-month follow-up assured the researchers that no other, more serious problems were overlooked.
Not surprisingly, the patients also reported the breath test was far easier to endure than the endoscopy -- and it was also far less expensive.
The researchers concluded that breath testing -- and not endoscopy -- should be the preferred method of testing dyspepsia patients for H. pylori.
Pochapin, however, says it's important to note this finding applies only to a specific group -- those with clearly defined indications of dyspepsia without any other significant or alarming symptoms that could indicate more serious disease.
And the researchers seem to agree. When what they call "sinister symptoms" are present, they advise that more invasive testing is essential.
This is an important distinction, Pochapin says, since some of the patients in the study were found to have peptic ulcers -- a problem that can sometimes mimic the symptoms of dyspepsia and would require endoscopy for a diagnosis to be made.
"It's imperative for people to understand that when symptoms could suggest something more serious, good clinical judgment must be used to determine whether or not endoscopy is necessary to rule out more extensive and significant disease," Pochapin says.
The one comforting aspect of the study, he says, is that researchers reported they did not miss any cancers even when non-invasive testing was used.
What To Do: For more information on dyspepsia, visit the Dyspepsia File Center for Current Research. To learn more about H. pylori, check out the Helicobacter Foundation.
