[Clinical summary of the first 500 patients in the gastrointestinal soldiers' clinic in Beilinson hospital].

INTRODUCTION: The Soldiers' Clinic for gastrointestinal diseases was established in the Rabin Medical Center in 2006, for better management of these problems. AIM: To evaluate the diagnosis and treatment in the first 500 soldiers treated in our clinic. METHODS: Demographic and clinical data were collected for every soldier: age, gender, main reason for referral, background diseases and medical family history. The number of visits was counted and the referrals for laboratory and diagnostic procedures computed. For every procedure, compliance, cost, diagnostic yield and its' proportion in comparison with the other referrals was performed. RESULTS: The main reasons for referral to our clinic were abdominal pain (46.6%), diarrhea (13.8%) and heartburn (9.4%). Family history of colorectal cancer was found in 20.6% of the soldiers. Out of 608 procedures performed 29.2% were positive. Hydrogen breath test for lactose intolerance was recommended for 9.6% and had the highest diagnostic yield of 52.0%. High yield was also found for 13C-urea breath test for Helicobacter pylori, gastroscopy, abdominal computerized tomography, and colonoscopy: 28.4%, 31.6%, 18.5% and 13.5% respectively. In comparison with abdominal ultrasound, the diagnostic yield was significantly better for gastroscopy and both breath tests. The total cost was NIS 360,244. A significant diagnosis was performed in 317 soldiers (63.4%). The average cost per diagnosis was NIS 1135.4. CONCLUSION: The Gastrointestinal Clinic for soldiers conducted by a senior experienced gastroenterologist is important for better diagnostic yield and cost-saving in this young population.

Helicobacter pylori recurrence and infection rate in Israeli adults.

INTRODUCTION: In developing countries the recurrence rate of Helicobacter pylori after successful eradication therapy is as high as 42%, while in developed countries it is estimated to be less than 3%. Such figures are very important in terms of determining clinical strategy and outcome. AIM: To estimate the recurrence rate of H. pylori in Israel using the database of the "Central H. Pylori Laboratory of Clalit Health Services". METHODS: The database was searched for patients who had undergone the [(13)C]-urea breath test ([(13)C]-UBT) for validation of the successful eradication of H. pylori or for evaluation of dyspepsia 7 years previously and for whom the result had been negative. These patients were invited to participate in the trial, fill a symptom questionnaire and undergo another [(13)C]-UBT. RESULTS: A In total, 65 patients participated; of these, 26 patients had tested negative in the first( 13)CUBT, indicating the successful eradication of H. pylori (Group A), and 39 had been tested for dyspepsia (Group B). One patient in each group had a positive [(13)C]-UBT - 3.84% in Group A and 2.56% in Group B (non-significant difference, NS). The mean annual H. pylori recurrence rate was calculated to be 0.55% and 0.37% in Group A and Group B patients, respectively (NS). CONCLUSION: Our results shown a very low re-infection or new infection rates in Israeli adults and are in line with other trials in developed countries; they do not support the a retesting program for patients after a successful eradication therapy.