TREATMENT OF HELICOBACTER-PYLORI INFECTIONS

The available literature on the relationship between several diseases and Helicobacter pylori (H. pylori) is reviewed. Duodenal ulcer, gastr ic ulcer, complicated peptic nicer, abdominal symptoms and gastroduode nal mucosal damage during the use of non-steroidal anti-inflammatory d rugs (NSAIDs), non-ulcer dyspepsia (NUD) and gastric malignancy are di scussed. The case for and against eradication is critically discussed. Eradication of H. pylori should be pursued in all patients with pepti c ulcer disease, whether they are using NSAIDs or not. Eradication of H. pylori in the treatment of NUD should be considered experimental. T reatment aimed at the eradication of H. pylori should be considered in all patients with low-grade malignant mucosa-associated lymphoid tiss ue (MALT) lymphoma and in all patients with Menetrier's disease. Final ly, this treatment should be considered in a subset of H. pylori-infec ted patients who possibly are at an increased risk of gastric cancer: patients with a strong family history of gastric carcinoma and patient s in need of long-term treatment with a proton-pump inhibitor. In view of the importance of patient compliance, the risk of side-effects and the possibility of inducing metronidazole resistance when treatment w ith a metronidazole-containing regimen is used, treatment aimed at the eradication of H. pylori should be carefully implemented and monitore d.