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 Printable version |
Guidelines on the eradication of Helicobacter pylori in 2008 |
Hépato-Gastro. Volume 15, Number 5, 363-70, Septembre-Octobre 2008, Mini-revue
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 Résumé
Article gratuit
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Author(s) : Jean-Dominique de Korwin |
Summary : Helicobacter pylori gastritis is associated with numerous digestive and extradigestive diseases. Its role in the etiology of gastroduodenal ulcers is well established. Successful eradication of the bacteria promotes healing of duodenal ulcers, prevents recurrence of gastric and duodenal ulcers and reduces complication rates. H. pylori and NSAIDs are independent risk factors for ulcers. Successful eradication of H. pylori reduces the risk of NSAIDs-induced ulcers. Prevention of ulcer recurrence associated with NSAIDs treatment demands an additional treatment with proton pump inhibitors (PPI). Eradication of H. pylori is an effective optional treatment for functional dyspepsia. Detection of H. pylori with non-invasive methods is a validated strategy when gastroscopy is not deemed necessary. H. pylori plays no significant role in GERD, but its eradication is an option in cases of prolonged treatment with PPI. H. pylori infection is the main cause of MALT lymphoma. Its eradication cures most limited lesions, whether low-grade or high-grade lymphomas. There are convincing proofs of its role in intestinal and diffuse distal gastric carcinomas. High-risk groups are patients with a personal history of superficial gastric cancer or family history of gastric cancer in first-degree relatives. Unexplained iron-deficiency anemia and idiopathic thrombocytopenic purpura are emerging indications for H. pylori eradication. European and American guidelines on management of H. pylori infection are more up to date than the French revised consensus of 1999 and set up the current indications for H. pylori infection diagnosis and treatment. |
Keywords : H. pylori, treatment, peptic ulcer, NSAID, MALT lymphoma, gastric cancer |
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