THE HELICOBACTER REVOLUTION .2. DIAGNOSIS AND THERAPY

The gold standard for the diagnosis of Helicobacter infection is the a nalysis of endoscopic biopsies. The C13-urea breath test allows a diag nosis of the infection reliably and with non invasive means. Serology can not differentiate between active and healed infection. In patients with ulcer disease and low grade MALT-lymphoma there is an absolute i ndication for Helicobacter treatment. In other cases such as functiona l dyspepsia, NSAID-gastropathy, reflux esophagitis, gastric carcinoma etc., it is not possible to give simple recommendations. The prophylac tic treatment of healthy carriers is, at present, not recommended. Opt imal treatment consists of omeprazole 2 x 20 mg, amoxicillin 2 x 1000 mg and clarithromycin 2 x 500 mg or of omeprazole 2 x 20 mg, metronida zole 2 x 400-500 mg and clarithromycin 2 x 250 mg, given for 7 days. T hese combinations have been registered by the German Drug Registration Agency (BfArM).