Helicobacter pylori: Diagnosis and treatment update

Helicobacter pylori is recognized as a major cause of upper gastrointestina l disorders. At present, treatment is recommended in H pylori-positive pati ents with active ulcers, a history of peptic ulcer disease, early-stage gas tric cancer after resection, or MALT lymphoma. Diagnosis of H pylori is acc omplished with either endoscopy or noninvasive tests (serology or urea brea th test). Treatment regimens for eradicating H pylori infection have evolve d from monotherapy to multidrug regimens involving two antibiotics and eith er a proton pump inhibitor (PPI) or a histamine(2)-receptor antagonist. The addition of PPls in particular has improved efficacy, decreased side effec ts, shortened treatment duration, and lowered costs. However, no treatment regimen has emerged from clinical trials as the therapeutic standard.