Treatment of Helicobacter pylori infection: management of patients with ulcer disease by general practitioners and gastroenterologists.

Knowledge of the importance of Helicobacter pylori infection is still fragmentary. Currently only a minority of patients with ulcers receive adequate eradication therapy. Ideally there should be no difference in the level of knowledge between general practitioners and gastroenterologists. Yet in practice there is a substantial difference. The results obtained in highly selected clinical trials do not reflect results of practice in the real world. The gap can only be narrowed through careful mass education. The role of testing for H pylori infection in primary care practice needs to be clarified and the problem of erratic treatment by general practitioners and specialists needs to be resolved. Adequate response to these problems will require the creation of "regional platforms" where both primary care physicians and specialists decide on empirical therapy, eradication strategy and referral of dyspeptic patients.