| Abstract: | The available literature on the relationship between severaldiseases and Helicobacter pylori (H. pylori) is reviewed. Duodenalulcer, gastric ulcer, complicated peptic ulcer, abdominal symptomsand gastroduodenal mucosal damage during the use of non-steroidalanti-inflammatory drugs (NSAIDs), non-ulcer dyspepsia (NUD)and gastric malignancy are discussed. The case for and againsteradication is critically discussed. Eradication of H. pylorishould be pursued in all patients with peptic ulcer disease,whether they are using NSAIDs or not. Eradication of H. pyloriin the treatment of NUD should be considered experimental. Treatmentaimed at the eradication of H. pylori should be considered inall patients with low-grade malignant mucosaassociated lymphoidtissue (MALT) lymphoma and in all patients with Menetrier'sdisease. Finally, this treatment should be considered in a subsetof H. pylori-infected patients who possibly are at an increasedrisk of gastric cancer: patients with a strong family historyof gastric carcinoma and patients in need of long-term treatmentwith a proton-pump inhibitor. In view of the importance of patientcompliance, the risk of side-effects and the possibility ofinducing metronidazole resistance when treatment with a metronidazole-containingregimen is used, treatment aimed at the eradication of H. pylorishould be carefully implemented and monitored. |
