Current concepts in the management of helicobacter pylori infection: The maastricht III consensus report

The European Helicobacter Study Group

Research output: Contribution to journalArticle

1586 Citations (Scopus)

Abstract

Background: Guidelines on the management of Helicobacter pylori, which cover indications for management and treatment strategies, were produced in 2000. Aims: To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylori eradication for the prevention of gastric cancer. Results: Eradication of H pylori infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (d) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a “test and treat” strategy if other causes are excluded. Eradication of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal antiinflammatory drugs (NSAIDs). H pylori eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a noninvasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylori infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. Conclusion: The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylori infection has the potential to reduce the risk of gastric cancer development.

Original languageEnglish (US)
Pages (from-to)772-781
Number of pages10
JournalGut
Volume56
Issue number6
DOIs
StatePublished - 2007

Fingerprint

Helicobacter Infections
Helicobacter pylori
Pylorus
Consensus
Stomach Neoplasms
Esophageal Diseases
Proton Pump Inhibitors
Gastroesophageal Reflux
Infection
Peptic Ulcer
Therapeutics
Anti-Inflammatory Agents
Guidelines
Atrophic Gastritis
Marginal Zone B-Cell Lymphoma
Bismuth
Breath Tests
Idiopathic Thrombocytopenic Purpura
Clarithromycin
Iron-Deficiency Anemias

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Current concepts in the management of helicobacter pylori infection : The maastricht III consensus report. / The European Helicobacter Study Group.

In: Gut, Vol. 56, No. 6, 2007, p. 772-781.

Research output: Contribution to journalArticle

The European Helicobacter Study Group. / Current concepts in the management of helicobacter pylori infection : The maastricht III consensus report. In: Gut. 2007 ; Vol. 56, No. 6. pp. 772-781.
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abstract = "Background: Guidelines on the management of Helicobacter pylori, which cover indications for management and treatment strategies, were produced in 2000. Aims: To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylori eradication for the prevention of gastric cancer. Results: Eradication of H pylori infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (d) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a “test and treat” strategy if other causes are excluded. Eradication of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are na{\"i}ve users of non-steroidal antiinflammatory drugs (NSAIDs). H pylori eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a noninvasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylori infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. Conclusion: The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylori infection has the potential to reduce the risk of gastric cancer development.",
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T1 - Current concepts in the management of helicobacter pylori infection

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AU - The European Helicobacter Study Group

AU - Malfertheiner, P.

AU - Megraud, F.

AU - O’Morain, C.

AU - Bazzoli, F.

AU - El-Omar, E.

AU - Graham, D.

AU - Hunt, R.

AU - Rokkas, T.

AU - Vakil, N.

AU - Kuipers, E. J.

AU - Andersen, Leif

AU - Atherton, John

AU - Asaka, Masahiro

AU - Bazzoli, Franco

AU - Bytzer, Peter

AU - Chan, Francio

AU - Coelho, Luiz Gonzaga Vaz

AU - De Wit, Niek

AU - Delchier, Jean Charles

AU - Di Mario, Francesco

AU - El-Omar, Emad

AU - Fock, Kwong Ming

AU - Forman, David

AU - Fujioka, Toshio

AU - Gasbarrini, Giovanni

AU - Genta, Robert

AU - Goh, K. L.

AU - Graham, David Y.

AU - Hirschl, Alexander

AU - Hungin, Pali

AU - Hunt, Richard

AU - Isakov, Vassili A.

AU - Jones, Roger

AU - Kist, Manfred

AU - Koletzko, Sibylle

AU - Kuipers, Ernst J.

AU - Kupcinskas, Limas

AU - Ladas, Spiros

AU - Lanas, Angel

AU - Machado, Jose

AU - Malfertheiner, Peter

AU - McColl, Kenneth E L

AU - Mégraud, Francio

AU - Michetti, Pierre

AU - Moayyedi, Paul

AU - Omorain, Colm

AU - Pilotto, Alberto

AU - Quina, Mario

AU - Rokkas, Theodore

AU - Sharma, Patreek

PY - 2007

Y1 - 2007

N2 - Background: Guidelines on the management of Helicobacter pylori, which cover indications for management and treatment strategies, were produced in 2000. Aims: To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylori eradication for the prevention of gastric cancer. Results: Eradication of H pylori infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (d) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a “test and treat” strategy if other causes are excluded. Eradication of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal antiinflammatory drugs (NSAIDs). H pylori eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a noninvasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylori infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. Conclusion: The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylori infection has the potential to reduce the risk of gastric cancer development.

AB - Background: Guidelines on the management of Helicobacter pylori, which cover indications for management and treatment strategies, were produced in 2000. Aims: To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylori eradication for the prevention of gastric cancer. Results: Eradication of H pylori infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (d) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a “test and treat” strategy if other causes are excluded. Eradication of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal antiinflammatory drugs (NSAIDs). H pylori eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a noninvasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylori infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. Conclusion: The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylori infection has the potential to reduce the risk of gastric cancer development.

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