Do not prescribe proton pump inhibitors to patients with liver cirrhosis, outside of established indications
In patients with chronic liver disease and portal hypertension, even though acid secretion is markedly reduced, PPI therapy is often used even in the absence of an acid-related disease, in order to prevent bleeding from hypertensive gastropathy. This approach is not...
Do not perform food intolerance tests except for those scientifically validated
The only validated diagnostic test is lactose breath-test for lactose intolerance. Others test such as VEGA-test, Cytotoxic test, serum specific IgG4 determination, hair analysis, intestinal permeability, salivary IgA, “bioresonance” techniques, fecal microbial...
Do not request surveillance colonoscopy for asymptomatic colonic diverticular disease without changes in symptoms
The term merely identifies presence of diverticula in the colon, characterized by a favorable course and, generally, absence of symptoms. Colonoscopy is not indicated in patients with asymptomatic colonic diverticulosis and in patients with symptomatic uncomplicated...
Do not request esophagogastroduodenoscopy in patients with recent onset of upper gastrointestinal symptoms younger than 50 years, without alarm features
Upper GI symptoms are very common, affecting 20 to 40% of the general population and the majority of them refers to dyspepsia. Guidelines suggest to perform EGD in dyspeptic patients aged over 45–60 years or in those presenting with alarm features, such as a family...The campaign DOING MORE DOES NOT MEAN DOING BETTER – CHOOSING WISELY ITALY is promoted by Italy’s Slow Medicine
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