TY - JOUR
T1 - Current concepts in the management of helicobacter pylori infection
T2 - The maastricht III consensus report
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
N1 - Publisher Copyright:
© 2007, BMJ Publishing Group. All rights reserved.
PY - 2007/1/1
Y1 - 2007/1/1
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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U2 - 10.1136/gut.2006.101634
DO - 10.1136/gut.2006.101634
M3 - Article
C2 - 17170018
AN - SCOPUS:34247844165
SN - 0017-5749
VL - 56
SP - 772
EP - 781
JO - Gut
JF - Gut
IS - 6
ER -