Are there more clinically important complications of Helicobacter pylori infection than peptic ulcer disease? A review of current literature

Helicobacter pylori gastritis (i.e. H. pylori infection and complications) is a focus of tremendous research activity today. Besides peptic ulcer dise ase, a large number of reports suggest that other diseases are associated w ith H. pylori. The International Agency for Research on Cancer sponsored by the World Hearth organization classified the bacterium as a group I carcin ogen in 1994. Population-based studies of H. pylori and gastric cancer in 1 991 showed an increased odds ratio, of 3-6, in infected patients, and a cal culation of odds ratios in different age groups showed a markedly increased odds ratio, to about 20, in younger ages. Studies of non-ulcer dyspepsia a nd the effect of cure of H. pylori show either none, small, or significant symptom relief, suggesting a positive effect in a subgroup of non-ulcer dys pepsia patients. Mucose-associated lymphoid tissue-lymphoma caused by H. py lori could be eradicated, at least in its mild forms. Barrett's ulcer is a possible PI. pylori-associated disease as well as gastroesophageal reflux d isease. Normal feedback in the acid regulation system is changed in infecte d patients, which may facilitate an increased gastroesophageal acidic reflu x. Gastropathy and/or peptic ulcer due to use of nonsteroidal antiinflammat ory drugs is probably aggravated by the infection. The infectious disease P . pylori gastritis is associated with a large number of complications, some of which are serious. There are no data showing any advantages of the infe ction. Giving anti-H. pylori therapy to infected patients should be regarde d as essential.