Helicobacter Pylori

Abstract

All infected patients with a peptic ulcer should be treated for H. pylori. The role of treating H. pylori in patients with undiagnosed dyspepsia or non-ulcer dyspepsia, those taking nonsteroidal anti-inflammatory medications, or with a family history of gastric cancer remains controversial. Triple therapies consisting of a proton pump inhibitor or ranitidine bismuth citrate and two antibiotics are the current standard of therapy for H. pylori. In general, dual therapies should no longer be used to treat H. pylori. Bismuth triple therapy consisting of bismuth, tetracycline, and metronidazole is a less expensive alternative to proton pump inhibitor-or ranitidine bismuth citrate-based triple therapies. However, bismuth triple therapy is hampered by frequent side effects and the need for qid dosing. In Europe, a 7-day course of therapy appears to be adequate. In the United States, 10-14 days of therapy are currently recommended. Metronidazole resistance in H. pylori strains varies geographically, and negatively influences the effectiveness of therapies containing this antibiotic. Clarithromycin resistance is relatively infrequent at the current time but may be rising in countries where this antibiotic is in use. If a patient remains infected after a course of therapy for H. pylori, the second treatment should avoid the antibiotics used initially.

Reversibility of atrophic gastritis and intestinal metaplasia after Helicobacter pylori eradication ‐ a prospective study for up to 10 years

“…However, such mechanism has not been clarified. Although AG and IM are risk factors for GC, they have not been included in absolute indication of H. pylori eradication . Furthermore, H. pylori eradication is not strongly recommended or covered by medical insurance for GC prevention, especially when the severity of AG and IM is high because of their uncertain reversibility.…”

Incidence and Etiology of Various Cancers in Kashmir Valley- A Comprehensive Review of Literature

“…Human herpes virus 8 (HHV-8) infections appear to be common agent in Kaposi sarcomas [52] . Helicobacter pyloriis the main cause of gastritis and peptic ulcer; infection may be lifelong if not treated with antibiotics [53] . Chronic H. pylori infection is incriminated in gastric carcinoma.…”

Testing for Helicobacter Pylori in the clinical setting

“…This recommendation can be supported by several arguments. Accepted 10-14 day regimens for H. pylori result in a cure rate of 80-90% (52). It is reasonable to expect that <50% of patients subjected to the "test and treat" strategy for dyspepsia will experience symptom resolution following therapy for H. pylori (53).…”