Management of Helicobacter pylori infection.
Helicobacter pylori is the cause of most peptic ulcer disease and a primary risk factor for gastric cancer. Eradication of the organism results in ulcer healing and reduces the risk of ulcer recurrence and complications. Testing and treatment have no clear value in patients with documented nonulcer dyspepsia; however, a test-and-treat strategy is recommended but for patients with undifferentiated dyspepsia who have not undergone endoscopy. In the office setting, initial serology testing is practical and affordable, with endoscopy reserved for use in patients with alarm symptoms for ulcer complications or cancer, or those who do not respond to treatment. Treatment involves 10- to 14-day multidrug regimens including antibiotics and acid suppressants, combined with education about avoidance of other ulcer-causing factors and the need for close follow-up. Follow-up testing (i.e., urea breath or stool antigen test) is recommended for patients who do not respond to therapy or those with a history of ulcer complications or cancer.
Meurer
Linda N
LN
Department of Family and Community Medicine, Medical College of Wisconsin, Milwaukee 53226-0509, USA. lmeurer@mcw.edu
Bower
Douglas J
DJ
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents / Q000627:therapeutic use*; D001944:Breath Tests; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination / Q000627:therapeutic use*; D016099:Endoscopy, Gastrointestinal; D016481:Helicobacter Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D010353:Patient Education as Topic; D010437:Peptic Ulcer / Q000188:drug therapy* / Q000382:microbiology*; D012307:Risk Factors; D012698:Serologic Tests
D000900:Anti-Bacterial Agents; D000897:Anti-Ulcer Agents