New concepts concerning management of Helicobacter pylori infection: 2 years after the Maastricht Consensus Report

In Maastricht, the European Helicobacter Pylori Study Group (EHPSG) establi shed consensus guidelines on the treatment of Helicobacter pylori (H. pylor i) at primary care and specialist levels. In spite of this consensus, a deb ate is still open among primary care physicians in many countries regarding the diagnostic and therapeutic approach to the infection. The,general prac titioner is frequently requested not only by dyspeptic patients but also by asymptomatic subjects to perform diagnostic tests and to prescribe eradica tion treatments. The policy of H . pylori eradication in patients with func tional dyspepsia is still controversial, but in light of the H. pylori infe ction as a risk factor for malignant lesions and ulcer; there is the ration ale for treatment. An emergent problem for general practitioners also conce rns the extradigestive diseases associated with H. pylori infection, with m ore studies needed before any kind of recommendation can be made. Indicatio ns for H. pylori treatment remain those indicated in the Maastricht Consens us Report. Concerning eradication regimens, new data have been obtained and , in addition to proton pump inhibitors (PPI)-based therapies, ranitidine b ismuth citrate-based regimens, have been shown to be efficacious.