From Bench to Bedside to Bug: An Update of Clinically Relevant Advances in the Care of Persons withHelicobacter pyloriAssociated Diseases Academic Article uri icon

  •  
  • Overview
  •  
  • Research
  •  
  • Identity
  •  
  • Additional Document Info
  •  
  • View All
  •  

abstract

  • In-depth meetings of the XIth International Workshop on Gastroduodenal Pathology andHelicobacter pyloriled to the presentation and discussion of extensive new data onH pyloriand its diseases. The mode of transmission ofH pyloriremains unclear, and it remains unknown why only a small proportion of infected individuals develop duodenal or gastric ulcer disease and even fewer develop gastric cancer. The role ofH pylorieradication in persons with uninvestigated dyspepsia remains controversial. New clinical trials ofH pyloritreatment show symptom relief and improvement in the quality of life of persons with functional dyspepsia, especially in those with ulcer-like or reflux-like dyspepsia. Clearly the move is toward symptom-based management of persons with dyspepsia, with fewer endoscopies being needed in the otherwise healthy young dyspeptic patients. It remains controversial whether eradicatingH pyloriin duodenal ulcer or functional dyspepsia increases the risk of subsequent development of gastroesophageal reflux disease. The one-week proton pump inhibitor-based triple regimens remain the gold standard ofH pyloritherapy, but some of the ranitidine bismuth citrate plus two antibiotic regimens also achieve an 80%H pylorieradication rate on an intention-to-treat basis. While the urea breath test remains the noninvasive test of choice, interesting new data are available on the use of stool antigen testing to diagnoseH pyloriinfection. The number ofH pylori-associated gastroduodenal diseases grows to include possible liver, vascular, immune and skin conditions.

publication date

  • 2000