Are there more clinically important complications of Helicobacter pylori infection than peptic ulcer disease? A review of current literature.
Helicobacter pylori gastritis (i.e. H. pylori infection and complications) is a focus of tremendous research activity today. Besides peptic ulcer disease, a large number of reports suggest that other diseases are associated with H. pylori. The International Agency for Research on Cancer sponsored by the World Health organization classified the bacterium as a group I carcinogen in 1994. Population-based studies of H. pylori and gastric cancer in 1991 showed an increased odds ratio, of 3-6, in infected patients, and a calculation of odds ratios in different age groups showed a markedly increased odds ratio, to about 20, in younger ages. Studies of non-ulcer dyspepsia and the effect of cure of H. pylori show either none, small, or significant symptom relief, suggesting a positive effect in a subgroup of non-ulcer dyspepsia patients. Mucosa-associated lymphoid tissue-lymphoma caused by H. pylori could be eradicated, at least in its mild forms. Barrett's ulcer is a possible H. pylori-associated disease as well as gastroesophageal reflux disease. Normal feedback in the acid regulation system is changed in infected patients, which may facilitate an increased gastroesophageal acidic reflux. Gastropathy and/or peptic ulcer due to use of nonsteroidal antiinflammatory drugs is probably aggravated by the infection. The infectious disease H. pylori gastritis is associated with a large number of complications, some of which are serious. There are no data showing any advantages of the infection. Giving anti-H. pylori therapy to infected patients should be regarded as essential.
Unge
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Department of Medicine, Länssjukhuset Gävle Sandviken, Sweden.
D004415:Dyspepsia / Q000382:microbiology; D005756:Gastritis / Q000382:microbiology; D016481:Helicobacter Infections / Q000150:complications* / Q000503:physiopathology; D016480:Helicobacter pylori; D006801:Humans; D010437:Peptic Ulcer / Q000382:microbiology; D013272:Stomach Diseases / Q000382:microbiology* / Q000503:physiopathology