title: Helicobacter pylori and nonmalignant diseases.
abstract: Peptic ulcer bleeding and recurrence rate are strongly linked to Helicobacter pylori infection even if nonsteroidal anti-inflammatory drugs (NSAIDs) play a relevant role in this setting. Further studies confirm that H. pylori eradication lowers the risk of recurrent peptic ulcer bleeding. Therefore, a test-and-treat strategy appears to be mandatory for patients with a history of ulcer bleeding and NSAIDs and/or aspirin use. Concerning gastroesophageal reflux disease (GERD), evidence clearly shows that H. pylori status has no effect on symptoms and treatment. Therefore, H. pylori treatment is not contraindicated in patients with GERD. The exact role of H. pylori in functional dyspepsia (FD) remains controversial. Novel possible mechanisms by which H. pylori may elicit dyspeptic symptoms include alterations of gastric motility, as well as endocrine and acid-secretory abnormalities. Hunger sensations, acid secretion, and gastrointestinal motility are regulated by ghrelin, particularly produced by the gastric enteroendocrine cell compartment. The improvement of symptoms correlates with enhanced plasma ghrelin levels. Apart from the need for more trials on this topic, these findings may give insight into the underlying pathophysiology of FD symptoms. Recent reports suggest that the presence of bacterial DNA in the oral cavity may be relevant to its transmission. A potential protective role of H. pylori on inflammatory bowel diseases needs to be better elucidated.
authors.affiliation: Department of Emergency and Organ Transplantation, University of Bari - AOU Policlinico, Piazza Giulio Cesare 10, 70124, Bari, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Ierardi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Goni
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Losurdo
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Mario
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016481:Helicobacter Infections / Q000188:drug therapy / Q000382:microbiology*; D016480:Helicobacter pylori / Q000187:drug effects / Q000502:physiology; D006801:Humans
chemical_list: D000900:Anti-Bacterial Agents
keywords: Peptic ulcer; dyspepsia; intestinal disorders; oral cavity