Dr Trefor Roscoe wrote:
> > I have just watched Watchdog on BBC!. It has given me acute
> > indigestion.
> >
> > Apparently 8 out of 10 GP's don't have a policy for treating and
> > following up ulcer patients so curing them and stopping them have
> > stomach cancer. It appears to be the GP's fault that there is a
> > problem. The solution is to go and get a blood or breath test at
> > your GP's practice.

If you had dyspepsia and were Hp positive would you want eradication
therapy? Would you want an endoscopy first? Would you want a breath
test after? (Assumes the reader has no other sinister symptoms or
signs, e.g. weight loss, abdo mass etc., and is under 45)


Paul Caldwell replied:
> It forgot to mention that the relationship between HP and gastric
> cancer has yet to be proven.

There's a new theory which suggests the falling rate of helicobacter
infection may be linked to not only the falling rate of gastric
cancer, but also to the *rising* rate of GORD and, possibly,
oesophageal cancer.

The proponents suggest that in some cases Hp causes a pan-gastritis
which actually reduces acid secretion and therefore protects against
GORD. Eradication therefore makes reflux worse.

I'm not so sure about this because one would expect dyspeptics - who
are more likely to be offered empirical eradication - to be the high
acid secretors.


> > Why do the journalists think this is a reasonable way of
> > educating the public!
> >
> > Prepare for the onslaught!

The Hp story looks set to become more complicated over time (see
above). Its a shame that populist "tabloid" consumer programmes seem
unable to convey these uncertainties.


Trims.

-- 
Dr Ian Trimble                        http://www.sherwood.demon.co.uk/
Sherwood Health Centre              
Elmswood Gardens                                 Tel: +44 115 962 4516
Nottingham     NG5 4AD                           Fax: +44 115 985 7899



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