The relationship between H pylori infection and the human host is proving to be complex. Risks posed by infection may involve differences in host susceptibility and relative virulence of H pylori strains, as well as other factors yet to be identified. Although some patients tolerate life-long infection without apparent clinical consequences, it is important to [...]
Continue reading " Risks and benefits of Helicobacter pylori eradication: CONCLUSIONS "
The widely used test and treat strategy in patients with symptoms of dyspepsia is a subject of ongoing debate. In patients under the age of 50 years with chronic dyspepsia but no alarm signals (such as unexplained weight loss or evidence of bleeding), noninvasive testing for H pylori infection and then treating the infection if [...]
Emerging controversies about the relationship between H pylori infection and the human host warrant a review of our current management guidelines. In Canada, where the prevalence of H pylori infection is decreasing and an increasing proportion of peptic ulcers are caused by factors other than H pylori, it is appropriate to ensure that the risks [...]
Controversies surrounding the possible relationship among H pylori infection, GERD and PPI therapy were not addressed in the 1999 revised guidelines. However, the available data do not permit definitive statements to be made. The risk posed by eradication of H pylori infection for GERD has not been proven, and would not preclude treatment in the [...]
Continue reading " Risks and benefits of Helicobacter pylori eradication: GASTRIC PATHOLOGY Part 2 "
The hypothesis that eradication of H pylori infection in duodenal ulcer patients increases the risk of GERD remains very controversial. The potential for H pylori infection of the fundus of the stomach to provide protection against GERD is one of the most frequently cited examples of a possible symbiosis between infection with this organism and [...]
Continue reading " Risks and benefits of Helicobacter pylori eradication: GASTRIC PATHOLOGY Part 1 "
Epidemiological evidence indicates that H pylori infection increases the risk of gastric adenocarcinoma by a multiple of 1.7 to 4.0. Postulated mechanisms include changes in the cell cycle, molecular characteristics and alterations in immune function induced by chronic gastritis, together with environmental factors. Chronic gastritis may progress to mucosal atrophy, intestinal metaplasia and then dysplasia, [...]
Continue reading " Risks and benefits of Helicobacter pylori eradication: GASTRIC CANCER "
One possible explanation for the disparity in results between studies is a failure to control for the presence of pre-existing GERD. It has been suggested that symptoms of GERD may be unmasked in some individuals once the more pronounced symptoms of peptic ulcer are controlled by eradication of the H pylori infection. However, some studies, [...]
Continue reading " Risks and benefits of Helicobacter pylori eradication: GERD Part 2 "
