title: Kyoto global consensus report on Helicobacter pylori gastritis.
abstract: OBJECTIVE
  To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate diagnostic assessment of gastritis and (4) when, whom and how to treat H. pylori gastritis.
  
  
  METHODS
  Twenty-three clinical questions addressing the above-mentioned four domains were drafted for which expert panels were asked to formulate relevant statements. A Delphi method using an anonymous electronic system was adopted to develop the consensus, the level of which was predefined as ≥80%. Final modifications of clinical questions and consensus were achieved at the face-to-face meeting in Kyoto.
  
  
  RESULTS
  All 24 statements for 22 clinical questions after extensive modifications and omission of one clinical question were achieved with a consensus level of >80%. To better organise classification of gastritis and duodenitis based on aetiology, a new classification of gastritis and duodenitis is recommended for the 11th international classification. A new category of H. pylori-associated dyspepsia together with a diagnostic algorithm was proposed. The adoption of grading systems for gastric cancer risk stratification, and modern image-enhancing endoscopy for the diagnosis of gastritis, were recommended. Treatment to eradicate H. pylori infection before preneoplastic changes develop, if feasible, was recommended to minimise the risk of more serious complications of the infection.
  
  
  CONCLUSIONS
  A global consensus for gastritis was developed for the first time, which will be the basis for an international classification system and for further research on the subject.
authors.affiliation: Department of Medicine, Jichi Medical University, Tochigi, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Sugano
authors.affiliation: Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Tack
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherland.
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.affiliation: Department of Medicine, Michael E DeBakery VA Medical Center, Baylor College of Medicine, Houston, USA.
authors.forename: David Y
authors.initials: DY
authors.lastname: Graham
authors.affiliation: Division of Applied Medicine, Institute of Medical Sciences, Aberdeen University, Aberdeen, UK.
authors.forename: Emad M
authors.initials: EM
authors.lastname: El-Omar
authors.affiliation: National Defense Medical College, Tokorozawa, Japan.
authors.forename: Soichiro
authors.initials: S
authors.lastname: Miura
authors.affiliation: Department of Gastroenterology, Kawasaki Medical School, Kurashiki, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.affiliation: Department of Cancer Preventive Medicine, Hokkaido University, Sapporo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asaka
authors.affiliation: Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan.
authors.forename: Naomi
authors.initials: N
authors.lastname: Uemura
authors.affiliation: Department of Gastroenterology, University of Magdeburg, Magdeburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Malfertheiner
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D004382:Duodenitis / Q000145:classification* / Q000188:drug therapy / Q000382:microbiology; D005756:Gastritis / Q000145:classification* / Q000188:drug therapy / Q000382:microbiology; D014943:Global Health; D016481:Helicobacter Infections / Q000145:classification* / Q000175:diagnosis / Q000188:drug therapy; D016480:Helicobacter pylori / Q000187:drug effects / Q000302:isolation & purification*; D006801:Humans; D038801:International Classification of Diseases / Q000145:classification*; D038622:Internationality; D007564:Japan; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents
keywords: FUNCTIONAL DYSPEPSIA; GASTRIC CANCER; GASTRITIS; HELICOBACTER PYLORI - GASTRITIS; HELICOBACTER PYLORI - TREATMENT