[Helicobacter pylori--when and how do gastroenterologists treat themselves? A clinical and practical survey]

To determine how often gastroenterologists know their own Helicobacter pylori status, how they diagnose the infection and what consequences they draw from the findings.

Between November 1995 and March 1996 questionnaires were sent to gastroenterologists in hospitals (592, with five not reached) or private practice in Germany (431, 12 not reached), with a response rate of 24.4% and 55.4%, respectively.

Of the 375 respondents 27 were female; the average age was 47.6 +/- 7.8 years. 151 knew their own H. pylori status (40.3%), with an infection rate of 55.6%. Most of the doctors had used noninvasive diagnostic tests (serology: 18.5%, breath test: 37.7%, serology + breath test 2.0%). 54 doctors (among them three without prior testing) had treated themselves between 1992 and 1995, ulcer or dyspepsia having been the most common indication (in 60%). Between 1992 and 1994 omeprazole plus amoxycillin was the most common form of treatment, while in 1995 a triple regimen with omeprazole and two antibiotics was most common during 1995. Either regimen was well tolerated in 85% of those treated, but about a quarter of doctors reported difficulties in compliance. Only half of the participants tested the result of treatment, similar numbers using either the breath test (n = 14) or biopsy (n = 13) for confirmation.

A significant percentage of gastroenterologists in Germany knew their own H. pylori status. However, the diagnostic procedures and indications for treatment often did not respond to recommended guidelines. The frequency of treatment and the regimen used mirrored the improved knowledge of the significance of H. pylori infection and the development of antibacterial treatment during the last few years.