Publication Date
11-1-2023
Journal
Current Opinion in Gastroenterology
DOI
10.1097/MOG.0000000000000981
PMID
37678189
PMCID
PMC10592071
PubMedCentral® Posted Date
11-1-2024
PubMedCentral® Full Text Version
Author MSS
Published Open-Access
yes
Keywords
Humans, Communicable Diseases, Drug Therapy, Combination, Helicobacter Infections, Helicobacter pylori, Proton Pump Inhibitors, Treatment Outcome, Helicobacter pylori, potassium competitive acid blockers, gastric cancer screening, therapy, diagnosis, empiric therapy
Abstract
PURPOSE OF REVIEW: The recognition that Helicobacter pylori should be considered and treated as an infectious disease has yet to fundamentally change diagnostic and treatment practices and has resulted in many controversies.
RECENT FINDINGS: We discuss the following controversies: whether the current 'per-patient' approach to H. pylori testing based on symptoms should be expanded to include achieving population-level H. pylori eradication, whether H. pylori should be approached as an infectious gastrointestinal disease similar to that of other infectious diseases of similar severity and outcome, whether treatment of H. pylori should be primarily empiric or based on antibiotic susceptibility and locally proven successful therapies as are other infectious diseases, whether it is necessary to obtain confirmation of treatment success in every patient treated for H. pylori , and whether potassium-competitive acid blockers should replace proton pump inhibitors in H. pylori therapy.
SUMMARY: Available guidelines and meta-analyses do not yet address H. pylori as an infectious disease. The diagnosis and management and treatment success of H. pylori infections trails behind that of other important infectious diseases. We provide new insights and propose changes in the traditional understanding required to modernize the management of H. pylori infections.