Helicobacter pylori:: Diagnosis and treatment update

Helicobacter pylori is recognized as a major cause of upper gastrointestinal disorders. At present, treatment is recommended in H pylori-positive patients with active ulcers, a history of peptic ulcer disease, early-stage gastric cancer after resection, or MALT lymphoma. Diagnosis of H pylori is accomplished with either endoscopy or noninvasive tests (serology or urea breath test). Treatment regimens for eradicating H pylori infection have evolved from monotherapy to multidrug regimens involving two antibiotics and either a proton pump inhibitor (PPI) or a histamine(2)-receptor antagonist. The addition of PPls in particular has improved efficacy, decreased side effects, shortened treatment duration, and lowered costs. However, no treatment regimen has emerged from clinical trials as the therapeutic standard.