Der Gastroenterologe

, Volume 1, Issue 4, pp 259–265 | Cite as

Indikationen zur Helicobacter-pylori-Eradikation

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Schwerpunkt: Helicobacter pylori
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Zusammenfassung

Das ständig wachsende Wissen über Helicobacter pylori und die mit der Infektion assoziierten Krankheitsmanifestationen haben zu einem differenzierten Konzept zum Einsatz der H.-pylori-Eradikationstherapien geführt. Entsprechend des Maastricht-Konsenses kann für Patienten mit Dyspepsie unter 45 Jahren eine Test-and-treat-Strategie angewendet werden, wenn nicht Symptome einer gastroösophagealen Refluxkrankheit überwiegen, keine nichtsteroidalen Antirheumatika (NSAR) eingenommen werden und Alarmsymptome fehlen. Für alle anderen Patienten wird eine endoskopische Diagnostik empfohlen und die Indikation zur Eradikation anhand der vorliegenden Befunde gestellt. Hier stellen die peptische Ulkuskrankheit, das MALT-Lymphom und die atrophische Gastritis die Hauptindikationen für eine Eradikationstherapie dar. Die Indikation zur H.-pylori-Therapie bei funktioneller Dyspepsie im Zusammenhang mit einer NSAR-Einnahme und bei verschiedenen extraalimentären Erkrankungen ist differenziert zu betrachten. Die Prophylaxe des Magenkarzinoms bleibt die größte Herausforderung.

Schlüsselwörter

Helicobacter pylori Eradikation Atrophische Gastritis MALT-Lymphom NSAR 

Indications for Helicobacter pylori eradication

An update

Abstract

The continuously growing knowledge on Helicobacter pylori and infection-related pathologies has led to a differentiated concept on the application of eradication therapies. According to the Maastricht consensus a test-and-treat strategy is recommended for patients under the age of 45 years, having excluded those with predominantly gastro-oesophageal reflux disease symptoms, non-steroidal anti-inflammatory drug (NSAID) users and those with alarm symptoms. All other patients with symptoms should be endoscopically examined and the indication for eradication therapy is dependent on the clinical findings. The main indications for eradication therapy are peptic ulcer disease, MALT lymphoma and atrophic gastritis. The therapy is advisable but needs to be differentially considered in patients with functional dyspepsia, NSAID intake and selected extra-alimentary diseases. Prevention of gastric carcinoma remains an important challenge.

Keywords

Helicobacter pylori Eradication Atrophic gastritis MALT lymphoma NSAID 
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Notes

Interessenkonflikt

Keine Angaben

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Copyright information

© Springer Medizin Verlag 2006

Authors and Affiliations

  1. 1.Klinik für GastroenterologieHepatologie und InfektiologieMagdeburgDeutschland

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