The case for treatment of dyspeptic patients infected with H-pylori

H. pylori is probably the commonest bacterial infection worldwide and assoc iated with a number of clinical outcomes including chronic active gastritis , peptic ulcer, gastric adenocarcinoma, gastric MALT lymphoma and possibly dyspepsia. Treatment to eradicate H. pylori infection has changed significa ntly the natural history of peptic ulcer disease and is now the recommended approach to patients with non-NSAID gastric and duodenal ulcers. Controver ies remain as to whether Ii. pylori infection is a cause of dyspepsia and n on-ulcer dyspepsia. However, results from several economic models evaluatin g a "test and treat" strategy have suggested that eradication of H, pylori infection as an intitial choice is the most cost-effective approach and has a long-term benefit in a significant proportion of patients with dyspepsia . The conclusion of H. pylori as a group 1 human carcinogen by the IARC and the subsequent analyses have added further to the recommendation for eradi cation of the infection.