Strategy for Treatment of Helicobacter pylori Infection in Adults I. Updated Indications for Test and Eradication Therapy Suggested in 2000
Authors: Nakajima, S.; Graham, D.Y.; Hattori, T.; Bamba, T.
Source: Current Drug Metabolism, Volume 6, Number 15, 1 October 2000 , pp. 1503-1514(12)
Publisher: Bentham Science Publishers
Abstract:
Since the report of culture of Helicobacter pylori in 1983, there has been increasing agreement that H. pylori infection is etiologically associated with a number of important diseases including chronic active gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, gastric polyps, gastric cancer, as well as suggestions that it may be involved in diseases outside the upper gastrointestinal tract. There have been a number of national and international consensus meetings to propose guidelines to treat H. pylori infection. The recommendations of these conferences are reviewed here and updated to include new indications and concepts regarding H. pylori eradication therapy. Eradication therapy is considered the standard of care for active or inactive peptic ulcer patients including those who use non-steroidal anti-inflammatory drugs (NSAIDs). Other strong indications include MALT lymphoma, hyperplastic polyps, hyperplastic gastropathy, post-endoscopic resection for gastric malignancy, and acute H. pylori gastritis. Other considerations include plan to use chronic NSAID therapy, plan for chronic anti-secretory therapy, and some extra-gastroduodenal diseases such as chronic ureterica. Non-investigated dyspepsia is an indication for diagnostic evaluation and eradication therapy for those with H. pylori infection, whereas non-ulcer dyspepsia (NUD) in which peptic ulcer disease has been excluded is not an indication for evaluation per se. Intervention studies are now in progress to test the hypothesis that prevention of gastric malignancy is an outcome of H. pylori eradication. Because the prevalence of H. pylori infection and the associated diseases such as peptic ulcer or gastric cancer differ among countries as well as different approvals for treatment are required by governments or insurance agencies, the acceptable indications of eradication therapy will, by necessity, vary among countries.Keywords: Eradication Therapy; Helicobacter pylori; Mucosa-associated lymphoid tissue (MALT) lymphoma; Non-steroidal anti-inflammatory drugs (NSAIDs); H. pylori gastritis; Non-ulcer dyspepsia (NUD); Peptic ulcer; Gastric cancer; Chronic dermatitis; Idiopathic thrombocytopenia; Gastritis; Non-ulcer Dyspepsia (NUD); Haperplastic Gastropathy; Menetrier's Disease; Gastric Polyps; Adenoma; Gastroesophageal Reflux Disease (GERD); Enterochromaffin-like (ECL) Cell Hyperplasia; Carcinoid Tumor; Extra-gastrointestinal Diseases
Document Type: Review article
DOI: http://dx.doi.org/10.2174/1381612003399112
Publication date: 2000-10-01
- Current Pharmaceutical Design publishes timely in-depth reviews covering all aspects of current research in rational drug design. Each issue is devoted to a single major therapeutic area. A Guest Editor who is an acknowledged authority in a therapeutic field has solicits for each issue comprehensive and timely reviews from leading researchers in the pharmaceutical industry and academia.
Each thematic issue of Current Pharmaceutical Design covers all subject areas of major importance to modern drug design, including: medicinal chemistry, pharmacology, drug targets and disease mechanism.
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- In this Subject: Pharmacology
- By this author: Nakajima, S. ; Graham, D.Y. ; Hattori, T. ; Bamba, T.

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