title: [Reflections on the marked changes of the prevalence of Helicobacter pylori infection and peptic ulcer disease in the last two decades].
abstract: A short overview is presented of some of the persistent questions of the relationship of Helicobacter pylori infection and peptic ulcer disease and about the increasing number of patients with idiopathic peptic ulcer disease. The relationship between the decrease of the prevalence of peptic ulcer disease in countries with marked decrease of Helicobacter pylori prevalence in the general population, including the Czech Republic, was discussed. Several possible causes of the decrease in Helicobacter pylori prevalence were noted (improving of socioeconomic conditions, such as low income and poor education, such as poor sanitation and overcrowding, bad hygienic conditions especially during childhood, the marked increase of Helicobacter pylori eradication rate, associated also with an extended therapy by macrolides or other antibiotics (amoxicillin, etc.) used for several conditions, often at a very young age, and sometimes by chance together with proton pump inhibitors, natural loss of the older generation, which had a higher HP-prevalence than the general population, the change of the stomach microbiome, etc.) but with the implication, that the real cause of these deep changes remains indistinctly identified.
authors.affiliation: II. Interní klinika LF UK a FN a Hepatogastroenterology s.r.o., Hradec Králové. bohumil.fixa@tiscali.cz
authors.forename: Fixa
authors.initials: F
authors.lastname: Bohumil
mesh_terms: D016481:Helicobacter Infections / Q000150:complications / Q000453:epidemiology*; D016480:Helicobacter pylori; D006801:Humans; D010437:Peptic Ulcer / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence