Letters to the Editor

Should Patients be Referred for Endoscopy?

Am Fam Physician. 2002 Oct 15;66(8):1402-1405.

to the editor: Thank you for the fine article by Drs. Meurer and Bower entitled,“Management of Helicobacter pylori Infection.”1 My only comment would regard the recommendation for family physicians to refer their patients “to a gastroenterologist for endoscopy.” Esophago-gastroduodenoscopy is a primary care procedure that is taught in many of our residency programs and at our own annual scientific assembly (along with colonoscopy).

With the prevalence of H. pylori infection demonstrated to be as high as 52 percent in the United States,2 it should be obvious that there are simply not enough gastroenterologists to see all of these patients (especially considering the primacy of screening colonoscopy over screening flexible sigmoidoscopy3). More family physicians need to step forward and accept the challenge of learning and providing these procedures for our patients.

REFERENCES

1. Meurer LN, Bower DJ. Management of Helicobacter pylori infection. Am Fam Physician. 2002;65:1327–36.

2. Graham DY, Malaty HM, Evans DG, Evans DJ Jr, Klein PD, Adam E. Epidemiology of Helicobacter pylori in an asymptomatic population in the United States. Effect of age, race, and socioeconomic status. Gastroenterology. 1991;100:1495–501.

3. Lieberman DA, Weiss DG. One-time screening for colorectal cancer with combined fecal occult-blood testing and examination of the distal colon. N Engl J Med. 2001;345:555–60.

Send letters to Kenneth W. Lin, MD, MPH, Associate Deputy Editor for AFP Online, e-mail: afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680.

Please include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the American Academy of Family Physicians permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.


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