Curbside Consultation in GERD: 49 Clinical Questions

Philip O. Katz, MD

Question 37: Ms. Smith Went To The Er With Chest Pain That Was Determined To Be Noncardiac. Serologies For H. Pylori Were Found To Be Positive In The Ed. I Have Considered Treating Her But Have Heard That This May Worsen Her Reflux. What Should I Do? (continued)

This question is as much interesting for the decision to do serological testing for Helicobacter pylori as the decision to treat the patient or not. A patient seen in the emergency room for noncardiac chest pain is not, in my opinion, a candidate for Helicobacter testing, as the potential etiologies for the pain do not include gastric ulcer, duodenal ulcer, or any syndrome that I know to be associated with H. pylori. I cannot recall any patient that I have treated who has experienced improvement in their chronic chest pain when Helicobacter has been eradicated. As such, this patient should…