title: Diagnosis and treatment of Helicobacter pylori infection.
abstract: National Danish guidelines for the diagnosis and treatment of Helicobacter pylori (Hp) infection have been approved by the Danish Society for Gastroenterology. All patients with peptic ulcer disease, gastric cancer, and MALT lymphoma should be tested for Hp. We also recommend testing in first degree relatives to patients with gastric cancer, in NSAID-naive patients, who need long-term NSAID therapy, and in patients presenting with dyspepsia and no alarm symptoms. Non-endoscoped patients can be tested with a urea-breath test or a faecal antigen test. Endoscoped patients can be tested with a rapid urease test. Proton pump inhibitor therapy should be stopped at least 1 week prior to Hp testing. All infected patients should be offered Hp eradication therapy. First-line treatment is 7-day triple therapy with a proton pump inhibitor and clarithromycine in combination with metronidazole or amoxicilline. Quadruple therapy for 2 weeks with bismuthsubsalicylate, tetracycline, metronidazole and a proton pump inhibitor is recommended in case of treatment failure. Hp testing should be offered to all patients after eradication therapy but is mandatory in patients with ulcer disease, noninvasive gastric cancer or MALT lymphoma. Testing after eradication should not be done before 4 weeks after treatment has ended.
authors.affiliation: Department of Medicine, Køge Hospital, Denmark. pmby@regionsjaelland.dk
authors.forename: Peter
authors.initials: P
authors.lastname: Bytzer
authors.forename: Jens Frederik
authors.initials: JF
authors.lastname: Dahlerup
authors.forename: Jens Ravn
authors.initials: JR
authors.lastname: Eriksen
authors.forename: Dorte Ejg
authors.initials: DE
authors.lastname: Jarbøl
authors.forename: Steffen
authors.initials: S
authors.lastname: Rosenstock
authors.forename: Signe
authors.initials: S
authors.lastname: Wildt
mesh_terms: D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000930:Antidiarrheals; D001729:Bismuth / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D003718:Denmark; D004359:Drug Therapy, Combination; D004415:Dyspepsia; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D018442:Lymphoma, B-Cell, Marginal Zone; D008795:Metronidazole / Q000627:therapeutic use; D009942:Organometallic Compounds / Q000627:therapeutic use; D010437:Peptic Ulcer / Q000188:drug therapy; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012459:Salicylates / Q000627:therapeutic use; D013274:Stomach Neoplasms; D013752:Tetracycline / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000930:Antidiarrheals; D009942:Organometallic Compounds; D054328:Proton Pump Inhibitors; D012459:Salicylates; D008795:Metronidazole; C015715:bismuth subsalicylate; D000658:Amoxicillin; D013752:Tetracycline; D017291:Clarithromycin; D001729:Bismuth