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Helicobacter pylori-associated diseases

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Abstract

Since the initial report 20 years ago by Marshall and Warren of an unidentified curved bacillus located on the gastric epithelium of patients with chronic active gastritis, the discovery of Helicobacter pylori and its association with a number of gastrointestinal diseases has revolutionized the field of gastroenterology. Although the association of H. pylori infection with peptic ulcer disease, chronic gastritis, mucosa-associated lymphoid tissue lymphoma, and gastric adenocarcinoma has been well documented over the past two decades, other areas remain less clear, including the role of H. pylori in gastropathy associated with nonsteroidal anti-inflammatory drugs, gastroesophageal reflux disease, and both uninvestigated and nonulcer dyspepsia. Although these areas still remain somewhat controversial, recent reports further clarify the role of H. pylori in these conditions. A review of the recent literature regarding H. pylori-associated diseases is presented along with recommendations for diagnosis and treatment of H. pylori infection.

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References and Recommended Reading Papers of particular interest, published recently, have been highlighted as: Of importance Of major importance

  1. Go MF: Review article: natural history and epidemiology of Helicobacter pylori infection. Aliment Pharmacol Ther 2002, 16(Suppl1):3–15.

    Article  PubMed  Google Scholar 

  2. Hawkey CJ, Tulassay Z, Szczepanski L, et al.: Randomised controlled trial of Helicobacter pylori eradication in patients on non-steroidal anti-inflammatory drugs: HELP NSAIDs study. Helicobacter Eradication for Lesion Prevention. Lancet 1998, 352:1016–1021.

    Article  PubMed  CAS  Google Scholar 

  3. Chan FK, Sung JJ, Chung SC, et al.: Randomised trial of eradication of Helicobacter pylori before non-steroidal antiinflammatory drug therapy to prevent peptic ulcers. Lancet 1997, 350:975–979.

    Article  PubMed  CAS  Google Scholar 

  4. Huang JQ, Sridhar S, Hunt RH: Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease; a meta-analysis. Lancet 2002, 359:14–22.

    Article  PubMed  CAS  Google Scholar 

  5. Chan FK, To KF, Wu JC, et al.: Eradication of Helicobacter pylori and risk of peptic ulcer in patients starting long-term treatment with non-steroidal anti-inflammatory drugs: a randomized trial. Lancet 2002, 359:9–13.

    Article  PubMed  CAS  Google Scholar 

  6. Malfertheiner P, M’egraud F, O’Morain C, et al.: Current concepts in the management of Helicobacter pylori infection: the Maastricht 2-2000 Consensus Report. Aliment Pharmacol Ther 2002, 16:167–180. These are the most recent European guidelines for the diagnosis and management of H. pylori infection and associated diseases based on recent advances in the literature and expert opinion.

    Article  PubMed  CAS  Google Scholar 

  7. Chan KL, Chung SC, Suen BY, et al.: Preventing recurrent upper gastrointestinal bleeding in patients with Helicobacter pylori infection who are taking low-dose aspirin or naproxen. N Engl J Med 2001, 344:967–973.

    Article  PubMed  CAS  Google Scholar 

  8. Van Leerdam ME, Tytgat GNJ: Helicobacter pylori infection in peptic ulcer hemorrhage [review]. Aliment Pharmacol Ther 2002, 16(Suppl-1):66–78.

    Article  PubMed  Google Scholar 

  9. Peura DA: The problem of Helicobacter pylori-negative idiopathic ulcer disease. Baillieres Best Pract Res Clin Gastroenterol 2000, 14:109–117.

    Article  PubMed  CAS  Google Scholar 

  10. Freston JW: The role of proton pump inhibitors in non-H. pylori-related ulcers [review]. Aliment Pharmacol Ther 2001, 15(Suppl-2):2–5.

    Article  PubMed  CAS  Google Scholar 

  11. McColl KEL, El-Nujumi AM, Chittajallu RS, et al.: A study of the pathogenesis of Helicobacter pylori negative chronic duodenal ulceration. Gut 1993, 34:762–768.

    PubMed  CAS  Google Scholar 

  12. Harris AW, Gummett PA, Phull PS, et al.: Recurrence of duodenal ulcer after Helicobacter pylori eradication is related to high acid output. Aliment Pharmacol Ther 1997, 11:331–334.

    Article  PubMed  CAS  Google Scholar 

  13. Watanabe T, Tada M, Nagai H, et al.: Helicobacter pylori infection induces gastric cancer in Mongolian gerbils. Gastroenterology 1998, 115:642–648. The first animal model to demonstrate a pathogenic link between H. pylori infection and subsequent development of gastric atrophy, metaplasia, dysplasia, and finally intestinal-type adenocarcinoma.

    Article  PubMed  CAS  Google Scholar 

  14. Sung JJY, Lin SR, Ching JYL, et al.: Atrophy and intestinal metaplasia one year after cure of H. pylori infection: a prospective randomized study. Gastroenterology 2000, 119:7–14.

    Article  PubMed  CAS  Google Scholar 

  15. Correa P, Fontham ET, Bravo JC, et al.: Chemoprevention of gastric dysplasia: a randomized trial of antioxidant supplements and anti-Helicobacter therapy. J Natl Cancer Inst 2000, 92:1881–1888.

    Article  PubMed  CAS  Google Scholar 

  16. Ohkusa T, Fujiki K, Takashimizu I, et al.: Improvement in atrophic gastritis and intestinal metaplasia in patients in whom Helicobacter pylori was eradicated. Ann Intern Med 2001, 134:380–386.

    PubMed  CAS  Google Scholar 

  17. Uemura N, Okamoto S, Yamamoto S, et al.: Helicobacter pylori infection and the development of gastric cancer. N Engl J Med 2001, 345:784–789. This paper presents some of the strongest evidence linking H. pylori to gastric cancer in humans, thus supporting a role for eradication as chemoprevention for gastric adenocarcinoma.

    Article  PubMed  CAS  Google Scholar 

  18. Howden C, Hunt RH: Guidelines for the management of Helicobacter pylori. Am J Gastroenterol 1998, 93:2330–2338.

    Article  PubMed  CAS  Google Scholar 

  19. Parsonnet J, Fiedman GD, Orentreich N, et al.: Risk for gastric cancer in people with CagA positive or CagA negative Helicobacter pylori infection. Gut 1997, 40:297–301.

    PubMed  CAS  Google Scholar 

  20. El-Omar EM, Carrington M, Chow WH, et al.: Interleukin-1 polymorphisms associated with increased risk of gastric cancer. Nature 2000, 404:398–402. The first report to describe host genetic factors playing a role in the response to H. pylori infection and risk for subsequent development of gastric adenocarcinoma.

    Article  PubMed  CAS  Google Scholar 

  21. El-Omar EM: The importance of interleukin 1 beta in Helicobacter pylori associated disease. Gut 2001, 48:743–747.

    Article  PubMed  CAS  Google Scholar 

  22. Stolte M, Bayerdörffer, Morgner A, et al.: Helicobacter and gastric MALT lymphoma. Gut 2002, 50(Suppl-III):iii19-iii24.

    Article  PubMed  Google Scholar 

  23. Chang CS, Chen LT, Yang JC, et al.: Isolation of a Helicobacter pylori protein, FldA, associated with mucosa-associated lymphoid tissue lymphoma of the stomach. Gastroenterology 1999, 117:82–88.

    Article  PubMed  CAS  Google Scholar 

  24. Ott G, Katzenberger T, Greiner A, et al.: The t(11;18)(q21;q21) chromosome translocation is a frequent and specific aberration in low-grade but not high-grade malignant non-Hodgkin’s lymphoma of the mucosa-associated lymphoid tissue (MALT)-type. Cancer Res 1997, 57:3944–3948.

    PubMed  CAS  Google Scholar 

  25. Liu H, Ruskon’e-Formeshaux A, Lavergue-Slove A, et al.: Resistance of t(11;18) positive gastric mucosa-associated lymphoid tissue lymphoma to Helicobacter pylori-eradication therapy. Lancet 2001, 357:39–40.

    Article  PubMed  CAS  Google Scholar 

  26. Liu H, Ye H, Ruskon’e-Fourmestraux A, et al.: T(11;18) is a marker for all stage gastric MALT lymphomas that will not respond to H. pylori eradication. Gastroenterology 2002, 122:1286–1294.

    Article  PubMed  CAS  Google Scholar 

  27. Morgner A, Thiede C, Bayerdörffer E, et al.: Long-term followup of gastric MALT lymphoma after H. pylori eradication. Curr Gastroenterol Rep 2001, 3:516–522.

    PubMed  CAS  Google Scholar 

  28. Thiede C, Wündisch T, Alpen B, et al.: Long-term persistence of monocloncal B cells after cure of Helicobacter pylori infection and complete histologic remission in gastric mucosaassociated lymphoid tissue B-cell lymphoma. J Clin Oncol 2001, 19:1600–1609.

    PubMed  CAS  Google Scholar 

  29. Talley NJ, Stanghellini V, Heading RC, et al.: Functional gastroduodenal disorders. Gut 1999, 45(Suppl 2):1137–1142.

    Google Scholar 

  30. Moayyedi P, Soo S, Deeks J, et al.: Systematic review and economic evaluation of Helicobacter pylori eradication treatment for non-ulcer dyspepsia. BMJ 2000, 321:659–664. A systematic review of 12 randomized, controlled trials evaluating the therapeutic benefit of H. pylori eradication in patients with NUD. Results showed a modest but significant therapeutic gain (elimination of symptoms) with eradication compared with placebo.

    Article  PubMed  CAS  Google Scholar 

  31. Laine L, Schoenfield P, Fennerty MB: Therapy for Helicobacter pylori in patients with non-ulcer dyspepsia: a meta-analysis of randomized controlled trials. Ann Intern Med 2001, 134:361–369. Recent meta-analysis of randomized, controlled trials assessing the effect of eradication therapy on symptoms of NUD. Results provided little support for eradication therapy in patients with NUD, further fueling the controversy over H. pylori eradication in the management of NUD.

    PubMed  CAS  Google Scholar 

  32. Fennerty MB: Helicobacter pylori and uninvestigated dyspepsia [review]. Aliment Pharmacol Ther 2002, 16(Suppl1):52–57.

    Article  PubMed  Google Scholar 

  33. Lassen AT, Pedersen FM, Bytzer P, et al.: Helicobacter pylori test-and-eradicate versus prompt endoscopy for management of dyspeptic patients: a randomized trial. Lancet 2000, 356:455–460.

    Article  PubMed  CAS  Google Scholar 

  34. McColl KE, Murray LS, Gillen D, et al.: Randomised trial of endoscopy with testing for Helicobacter pylori compared with non-invasive H pylori testing alone in the management of dyspepsia. BMJ 2002, 324:999–1002.

    Article  PubMed  CAS  Google Scholar 

  35. Vakil NB: Gastro-esophageal reflux disease and Helicobacter pylori infection [review]. Aliment Pharmacol Ther 2002, 16(Suppl 1):47–51.

    Article  PubMed  Google Scholar 

  36. Moayyedi P, Bardhan C, Young L, et al.: Helicobacter pylori eradication does not exacerbate reflux symptoms in gastroesophageal reflux disease. Gastroenterology 2001, 121:1120–1126.

    Article  PubMed  CAS  Google Scholar 

  37. Kuipers EJ, Uyterlinde AM, Peña AS, et al.: Increase of Helicobacter pylori associated corpus gastritis during acid suppressive therapy: implications for long-term safety. Am J Gastroenterol 1995, 90:1401–1406.

    PubMed  CAS  Google Scholar 

  38. Freston JW: Long-term acid control and proton pump inhibitors: interactions and safety issues in perspective. Am J Gastroenterol 1997, 92(Suppl):51S-57S.

    PubMed  CAS  Google Scholar 

  39. Vaira D, Gatta L, Ricci C, Miglioli M: Diagnosis of Helicobacter pylori infection [review]. Aliment Pharmacol Ther 2002, 16(Suppl 1):16–23.

    Article  PubMed  Google Scholar 

  40. Veldhuyzen van Zanten SJO, Flook N, Chiba N, et al.: An evidence-based approach to the management of uninvestigated dyspepsia in the era of Helicobacter pylori. CMAJ 2000, 162(Suppl12):S3-S23.

    Google Scholar 

  41. Jolton J: Clinical relevance of culture: why, how, and when. Helicobacter 1997, 2(Suppl 1):S25-S33.

    Google Scholar 

  42. Owen RJ: Molecular testing for antibiotic resistance in Helicobacter. Gut 2002, 50:285–289.

    Article  PubMed  CAS  Google Scholar 

  43. Fischbach LA, Goodman KJ, Feldman M, Aragaki C: Sources of variation of Heliobacter pylori treatment success in adults worldwide: a meta-analysis. Int J Epidemiol 2002, 31:128–139.

    Article  PubMed  Google Scholar 

  44. Lind T, Megraud F, Unge P, et al.: The MACH2 study: role of omeprazole in eradication of Helicobacter pylori with 1-week triple therapies. Gastroenterology 1999, 116:248–253.

    Article  PubMed  CAS  Google Scholar 

  45. Bock H, Koop H, Lehn N, Heep M: Rifabutin-based triple therapy after failure of Helicobacter pylori eradication treatment: preliminary experience. J Clin Gastroenterol 2000, 31:222–225.

    Article  PubMed  CAS  Google Scholar 

  46. Graham DY, Osata MS, Hoffman J, et al.: Furazolidone combination therapies for Helicobacter pylori infection in the United States. Aliment Pharmacol Ther 2000, 14:211–215.

    Article  PubMed  CAS  Google Scholar 

  47. Al-Eidan FA, McElnay JC, Scott MG, et al.: Management of Helicobacter pylori eradication: the influence of structured counseling and follow-up. J Clin Pharmacol 2001, 53:163–171.

    Google Scholar 

  48. Kusters JG: Recent developments in Helicobacter pylori vaccination. Scand J Gastroenterol 2001, 36(Suppl 234):15–21.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Virginia Health Systems, PO Box 800708, 22908-0708, Charlottesville, VA, USA

    Michael K. Sanders MD & David A. Peura MD

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  1. Michael K. Sanders MD
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  2. David A. Peura MD
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Sanders, M.K., Peura, D.A. Helicobacter pylori-associated diseases. Curr Gastroenterol Rep 4, 448–454 (2002). https://doi.org/10.1007/s11894-002-0019-x

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  • DOI: https://doi.org/10.1007/s11894-002-0019-x

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