Has Helicobacter pylori eradication for peptic ulcer been overrated?
Discovery of Helicobacter pylori has changed the life cycle of peptic ulcer disease (PUD). However, PUD does not completely disappear after elimination of H. pylori. Some ulcers recur even after successful eradication of H. pylori in non-users of non-steroidal anti-inflammatory drug (NSAID). In addition, the incidence of H. pylori-negative, non-NSAID PUD (idiopathic PUD) is reported to increase with time. Moreover, H. pylori-positive ulcers are not always H. pylori-induced ulcers because there are two paradoxes of the H. pylori myth: the existence of H. pylori-positive non-recurring ulcer and recurring ulcer after cure of H. pylori infection. Taken together, H. pylori is not the only cause of peptic ulcer disease. Therefore, it is still necessary to seriously consider the pathophysiology and the management of the ulcers, which may exist after elimination of H. pylori.
Arakawa
Tetsuo
T
Department of Gastroenterology, Osaka City University Graduate Medical School, Osaka.
Higuchi
Kazuhide
K
Fujiwara
Yasuhiro
Y
Tominaga
Kazunari
K
Watanabe
Toshio
T
Shiba
Masatsugu
M
Oshitani
Nobuhide
N
Matsumoto
Takayuki
T
D015984:Causality; D016481:Helicobacter Infections / Q000188:drug therapy*; D016480:Helicobacter pylori; D006801:Humans; D010437:Peptic Ulcer / Q000382:microbiology*; D014945:Wound Healing