Helicobacter pylori: consensus and controversy.
Helicobacter pylori is uniquely adapted to colonize the human stomach. Infection leads to a range of subclinical and clinical outcomes that depend on properties of the infecting strain, the host, and the environment. Eradication therapy is indicated for infected persons who develop peptic ulcer disease or gastric lymphoma or who are beginning long-term treatment with nonsteroidal anti-inflammatory drugs. However, treatment may worsen gastroesophageal reflux disease and increase the risk of esophageal cancer. H. pylori infections can be diagnosed noninvasively and can be eradicated with approximately 85% success by a variety of multidrug, 7-14-day regimens. Unfortunately, antibiotic resistance is affecting treatment effectiveness in the United States and abroad. A more complete understanding of the variation in H. pylori pathogenesis should lead to clearer recommendations about treatment for infected persons who have neither peptic ulcer disease nor gastric lymphoma.
Division of Epidemiology and Biostatistics, University of Illinois-Chicago School of Public Health, Chicago, IL, 60612, USA. doug@uic.edu
Douglas J
DJ
Passaro
E Julia
EJ
Chosy
Julie
J
Parsonnet
D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology*; D016480:Helicobacter pylori / Q000472:pathogenicity / Q000502:physiology*; D006801:Humans; D008223:Lymphoma / Q000209:etiology; D010437:Peptic Ulcer / Q000209:etiology; D013274:Stomach Neoplasms / Q000209:etiology