K. W. Wong

Trends in the prevalence of peptic ulcer disease and Helicobacter pylori infection in family physician‐referred uninvestigated dyspeptic patients in Hong Kong

Background:  Peptic ulcer disease is mainly caused by Helicobacter pylori infection and the use of non‐steroidal anti‐inflammatory drugs.

Clinical and endoscopic characteristics of non-Helicobacter pylori, non-NSAID duodenal ulcers: A long-term prospective study

The proportion of duodenal ulcers not associated with Helicobacter pylori infection or the use of non‐steroidal anti‐inflammatory drugs (NSAIDs) is increasing.

High prevalence of mixed infections by Helicobacter pylori in Hong Kong: Metronidazole sensitivity and overall genotype

Diversity in metronidazole susceptibility and genotypes of Helicobacter pylori have been reported with varying results in different areas.

13C‐urea breath test without a test meal is highly accurate for the detection of Helicobacter pylori infection in Chinese

Conventional 13C‐urea breath testing (13C‐UBT) includes a test meal to delay gastric emptying, which, theoretically, improves the accuracy of the test. Citric acid has been proposed as the best test meal. However, recent studies have suggested that a test meal may not be necessary.

A rapid-release 50-mg tablet-based 13C-urea breath test for the diagnosis of Helicobacter pylori infection

Background : Recently, a rapid‐release 100‐mg 13C‐urea tablet with citrate supplement (Diabact UBT) showed excellent performance in a European population.

Update on Clarithromycin Resistance in Helicobacter pylori in Hong Kong and Its Effect on Clarithromycin-Based Triple Therapy

Aim: To determine the antibiotic susceptibility of Helicobacter pylori and evaluate the efficacy of a clarithromycin-based triple therapy in relation to antibiotic resistance. Methods: Consecutive patients referred for upper endoscopy due to dyspeptic symptoms were recruited. Gastric biopsies were obtained for the CLO test, histology and culture. Antibiotic susceptibility was assessed by the E-test. Patients with H. pylori infection received rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1,000 mg, all twice daily for 7 days. Results: Of 234 patients recruited, 124 were H. pylori-positive and culture was successful in 102 patients. The updated prevalences of resistance to clarithromycin, amoxicillin and metronidazole were 7.8, 0 and 39.2%, respectively. A total of 86 patients received 1-week triple therapy with rabeprazole 20 mg, clarithromycin 500 mg, and amoxicillin 1,000 mg, all twice daily, and 81 patients attended the follow-up test. Eradication rates by per-protocol and intention-to-treat analysis were 92.6 and 87.2%, respectively. The eradication rate by per protocol was significantly higher in patients with clarithromycin-susceptible strains than in those with clarithromycin-resistant strains (98.6 vs. 28.6%, p < 0.001). Conclusion: Clarithromycin resistance reduces the clinical efficacy of clarithromycin-based triple therapy. However, due to the low prevalence of clarithromycin resistance, clarithromycin-based therapy is still the first choice for clinical use.

Prevalence and time trend of intestinal metaplasia in Hong Kong

Background and Methods:  Upper endoscopy records from 1998 to 2003 were reviewed. The demographic data, endoscopic diagnosis, results of rapid urease test and the absence or presence of intestinal metaplasia (IM) in histology were reviewed, to evaluate the prevalence of IM and Helicobacter pylori (Hp) infection over time in Hong Kong.

Twenty‐minute 50 mg 13C‐urea breath test without test meal for the diagnosis of Helicobacter pylori infection in Chinese

We have previously shown that the 75 mg 13C‐urea breath test without citrate test meal is highly accurate for the diagnosis of Helicobacter pylori infection in Chinese subjects. A lower dose 50 mg 13C‐urea breath test protocol with a sampling time at 20 min has not been validated previously.

Evaluation of a new referral system for the management of dyspepsia in Hong Kong: Role of open-access upper endoscopy: Open-access upper endoscopy

Background: In the management of dyspepsia, upper endoscopy is an important component. In our locality, patients requiring upper endoscopy are conventionally referred to specialist clinics by family physicians. We have introduced the first open‐access upper endoscopy service in Hong Kong, which has allowed family physicians to arrange endoscopy without prior specialist consultation. A study on the outcome of open‐access upper endoscopy in contrast with the conventional referral system was conducted.