H. Pylori Testing for Patients With Non-specific Upper Abdominal Pain in the Emergency Department
H. Pylori Testing for Patients With Non-specific Upper Abdominal Pain in the Emergency Department
This pilot study aims to estimate the prevalence of Helicobacter pylori (H. pylori)
 colonization in patients presenting with non-specific abdominal pain (NSAP) in an urban
 academic emergency department (ED) located in Washington, DC.
The major goal is to study the prevalence of H. pylori using the 13C Urea Breath Test (UBT)
 in emergency department (ED) patients with non-specific abdominal pain. The investigators
 plan to enroll 250 patients during the pilot stage of this study. This T2 translational trial
 aims to apply recommended guidelines for the investigation and management of NSAP and
 dyspepsia into the practical arena of ED clinical care. The "test-and-treat" approach to
 symptomatic H. pylori infection has been endorsed by the American Gastroenterological
 Association (AGA). Patients who test positive for H. pylori by UBT will be treated with
 clarithromycin-based triple medication therapy as recommended by the American College of
 Gastroenterology (ACG) at the discretion of the treating physician. The rationale is that
 successful identification of H. pylori in the ED and initiation of treatment may reduce
 future risk of gastritis, gastric lymphoma, and gastric cancer, and is cost-effective through
 reduction of future healthcare costs and symptom severity. Study subjects will be followed
 for medication compliance, resolution of symptoms, and ability to obtain outpatient
 follow-up. As part of this study, the investigators will be collecting important information
 on the ED evaluation of abdominal pain.
Inclusion Criteria:

 For any patient with chief complaint of "ABD", "STOM", "EPIG", "CHEST", "NAUS" "Do you have
 pain or discomfort or burning in your upper abdomen as the main reason for coming to ER
 today?"

 Exclusion Criteria:

 -  The patient LESS than 18 years old.

 -  Patient does NOT speak English NOR has reliable adult translator.

 -  Patient does NOT have capacity to give consent? (confused/intoxicated/etc.)

 -  The patient currently is on antibiotics.

 -  The patient currently is on a PPI. (eg. Prilosec [omeprazole]), protonix
 [pantoprazole], prevacid [lansoprazole], aciphex [rabeprazole], nexium [esomeprazole]

 -  The patient has taken bismuth or pepto-bismol today.

 -  The patient is known to be or suspected to be pregnant.

 -  The patient UNABLE to walk to H.pylori Breath test.

 -  The patient had "recent" negative H.pylori test for same symptoms.

 -  There an "obvious alternative cause" for pain (per attending).