Article: Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report.
2006 Volume 56, Issue 6, Page(s) 772–781
Abstract: ... at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis ... Background: Guidelines on the management of Helicobacter pylori, which cover indications ... of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD ...
| Abstract | Background: Guidelines on the management of Helicobacter pylori, which cover indications for management and treatment strategies, were produced in 2000. Aims: To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylori eradication for the prevention of gastric cancer. Results: Eradication of H pylori infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (d) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a "test and treat" strategy if other causes are excluded. Eradication of H pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal anti-inflammatory drugs (NSAIDs). H pylori eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a non-invasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylori infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. Conclusion: The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylori infection has the potential to reduce the risk of gastric cancer development. |
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| MeSH term(s) | Adult ; Anti-Bacterial Agents/therapeutic use ; Child ; Drug Resistance, Bacterial ; Dyspepsia/microbiology ; Gastroesophageal Reflux/microbiology ; Helicobacter Infections/complications ; Helicobacter Infections/diagnosis ; Helicobacter Infections/drug therapy ; Helicobacter pylori ; Humans ; Lymphoma, B-Cell, Marginal Zone/microbiology ; Stomach Neoplasms/microbiology ; Stomach Neoplasms/prevention & control | |||||
| Chemical Substances | Anti-Bacterial Agents | |||||
| Language | English | |||||
| Publishing date | 2006-12-14 | |||||
| Publishing country | England | |||||
| Document type | Consensus Development Conference ; Journal Article ; Research Support, Non-U.S. Gov't | |||||
| ZDB-ID | 80128-8 | |||||
| ISSN | 1468-3288 ; 0017-5749 | |||||
| ISSN (online) | 1468-3288 | |||||
| ISSN | 0017-5749 | |||||
| DOI | 10.1136/gut.2006.101634 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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