Helicobacter Pylori.
Background: Infection with Helicobacter pylori (H. pylori) is a major pathogenic factor for gastroduodenal ulcer disease and gastric carcinoma, as well as for other types of gastric and extragastric disease. As a result of changing epidemiologic conditions (e.g., immigration), changing resistance pa...
| Publicado en: | Deutsches Ärzteblatt International Vol. 115; no. 25; pp. 429 - 437 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Deutscher Aerzte-Verlag GmbH
6/22/2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130716735&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 130716735 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18660452 5F0N jtl: Deutsches Ärzteblatt International issn: 18660452 maglogo: N pubinfo: dt: 6/22/2018 vid: 115 iid: 25 pid: 25312 pub: Deutscher Aerzte-Verlag GmbH artinfo: ui: 130716735 10.3238/arztebl.2018.0429 130716735 ppf: 429 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Helicobacter Pylori. aug: au: Fischbach, Wolfgang Malfertheiner, Peter affil: Department II, Gastroenterology and Oncology, Klinikum Aschaffenburg -Alzenau GmbH, Academic Teaching Hospital of the University of Würzburg sug: ab: Background: Infection with Helicobacter pylori (H. pylori) is a major pathogenic factor for gastroduodenal ulcer disease and gastric carcinoma, as well as for other types of gastric and extragastric disease. As a result of changing epidemiologic conditions (e.g., immigration), changing resistance patterns with therapeutic implications, and new knowledge relating to the indications for pathogen eradication, the medical management of H. pylori is a dynamic process in need of periodic reassessment. Methods: This review is based on pertinent publications retrieved by a selective search in PubMed and the Cochrane Database, with particular attention to three international consensus reports and the updated German S2k guideline. Results: H. pylori is now dealt with as an infection, whether or not the infected individual has symptoms or suffers from an H.-pylori-induced illness. H.-pylori-associated dyspepsia and functional dyspepsia are distinct entities that can only be diagnosed when competing elements in the differential diagnosis have been ruled out. H. pylori can be detected with noninvasive methods (13C-urea breathing test, stool antigen detection) and with invasive methods (histology, culture, rapid urease test). An important consideration for treatment is that primary clarithromycin resistance is common in many groups of patients; in Germany, its prevalence is now 10.9%. Primary treatment can be with either standard triple therapy (clarithromycin and amoxicillin or metronidazole) or bismuth-containing quadruple therapy. Treatment for 10 to 14 days is more likely to eradicate the pathogen than treatment for 7 days. When H. pylori infection is initially diagnosed in a patient over age 50, gastritis risk stratification should be performed by means of endoscopic biopsy and histologic examination. Conclusion: The new, clinically relevant developments that are presented and commented upon in this review now enable evidence-based management of H. pylori infection. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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