Clinical trial: prolonged beneficial effect of <i>Helicobacter pylori</i> eradication on dyspepsia consultations – the Bristol Helicobacter Project

Harvey, R.F.; Lane, J. Athene; Nair, Prakash; Egger, Matthias; Harvey, Ian; Donovan, JL; Murray, LJ

doi:10.1111/j.1365-2036.2010.04363.x

Cited by 59 publications

(48 citation statements)

References 27 publications

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“…In the UK, the Bristol Helicobacter Project randomized 1517 H. pylori -positive adults to treatment for H. pylori infection or placebo and followed them prospectively ( 35 ). Among those treated for the infection, of whom over 90% achieved successful eradication, there was a small but statistically signifi cant ( P <0.05) reduction in subsequent consultations at the primary care level for dyspeptic complaints.…”

Section: Dyspepsia (Uninvestigated)mentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,266

1,505

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Helicobacter pylori ( H. pylori ) infection is a common worldwide infection that is an important cause of peptic ulcer disease and gastric cancer. H. pylori may also have a role in uninvestigated and functional dyspepsia, ulcer risk in patients taking low-dose aspirin or starting therapy with a non-steroidal anti-infl ammatory medication, unexplained iron defi ciency anemia, and idiopathic thrombocytopenic purpura. While choosing a treatment regimen for H. pylori , patients should be asked about previous antibiotic exposure and this information should be incorporated into the decision-making process. For fi rst-line treatment, clarithromycin triple therapy should be confi ned to patients with no previous history of macrolide exposure who reside in areas where clarithromycin resistance amongst H. pylori isolates is known to be low. Most patients will be better served by fi rst-line treatment with bismuth quadruple therapy or concomitant therapy consisting of a PPI, clarithromycin, amoxicillin, and metronidazole. When fi rst-line therapy fails, a salvage regimen should avoid antibiotics that were previously used. If a patient received a fi rst-line treatment containing clarithromycin, bismuth quadruple therapy or levofl oxacin salvage regimens are the preferred treatment options. If a patient received fi rst-line bismuth quadruple therapy, clarithromycin or levofl oxacin-containing salvage regimens are the preferred treatment options. Details regarding the drugs, doses and durations of the recommended and suggested fi rst-line and salvage regimens can be found in the guideline. Asia and Central and South America ( 8,22 ). Th ere is, however, preliminary evidence that it may be falling in some previously high prevalence areas ( 22 ). People immigrating to North America from Asia and other parts of the world have a much higher prevalence of the infection than people born in North America ( 23 ). In one study, the seroprevalence among immigrants from East Asia was 70.1% ( 24 ). Hispanic immigrants to North America have higher rates of the infection than fi rst-or second-generation Hispanics who were born here ( 25 ). QUESTION 2: WHAT ARE THE INDICATIONS TO TEST FOR, AND TO TREAT, H. PYLORI INFECTION? RecommendationsSince all patients with a positive test of active infection with H. pylori should be off ered treatment, the critical issue is which patients should be tested for the infection (strong recommendation, quality of evidence: not applicable), All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H. pylori infection. Th ose who test positive should be off ered treatment for the infection (strong recommendation, quality of evidence: high for active or history of PUD, low for MALT lymphoma, low for history of endoscopic resection of EGC).In patients with uninvestigated d...

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Section: Dyspepsia (Uninvestigated)mentioning

confidence: 99%

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Chey

Leontiadis

Howden

et al. 2017

American Journal of Gastroenterology

1,266

1,505

View full text Add to dashboard Cite

show abstract

“…The benefit is likely to be highest in communities with a high risk of gastric cancer (where all these randomised trials were conducted.) However, it may also be cost-effective in developed countries because randomised trials have shown that population H. pylori screening and treatment reduces dyspepsia costs 327 328. This could result in the programme being cost neutral.…”

Section: Working Group 4: Prevention/public Healthmentioning

confidence: 99%

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

Malfertheiner

Mégraud

O’Moráin

et al. 2016

Gut

2,444

3,052

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“…In a randomized controlled trial, 1,517 patients with functional dyspepsia were followed for up to 7 years after H pylori eradication. A cumulative gain over time was shown, with a 25% reduction in medical visits due to dyspeptic complaints in patients who had eradicated the bacteria (89) . H pylori eradication in patients with functional dyspepsia is now a consensus recommendation established by leading experts in different regions of the world (132,141,192,207) .…”

Section: Statementmentioning

confidence: 99%

“…Less consistent data having similar results are also obtained using prokinetic agents, H 2 blocker antagonists, tricyclic antidepressants and serotonin reuptake inhibitors (112) . Recent evidence has demonstrated the long-term effects of H pylori eradication in reducing consultations for dyspeptic complaints (89,129) . Cost-effectiveness analyses show variations in different regions of the world, depending on differing factors, with the best results obtained in regions where the infection is highly prevalent.…”

Section: Statementmentioning

confidence: 99%

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

Coelho

Maguinilk

Zaterka³

et al. 2013

Arq. Gastroenterol.

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Significant progress has been obtained since the Second Brazilian Consensus Conference on Helicobacter pylori Infection held in 2004, in São Paulo, SP, Brazil, and justify a third meeting to establish updated guidelines on the current management of H. pylori infection. The Third Brazilian Consensus Conference on H pylori Infection was organized by the Brazilian Nucleus for the Study of Helicobacter, a Department of the Brazilian Federation of Gastroenterology and took place on April 12-15, 2011, in Bento Gonçalves, RS, Brazil. Thirty-one delegates coming from the five Brazilian regions and one international guest, including gastroenterologists, pathologists, epidemiologists, and pediatricians undertook the meeting. The participants were allocated in one of the five main topics of the meeting: H pylori, functional dyspepsia and diagnosis; H pylori and gastric cancer; H pylori and other associated disorders; H pylori treatment and retreatment; and, epidemiology of H pylori infection in Brazil. The results of each subgroup were submitted to a final consensus voting to all participants. Relevant data were presented, and the quality of evidence, strength of recommendation, and level of consensus were graded. Seventy per cent and more votes were considered as acceptance for the final statement. This article presents the main recommendations and conclusions to guide Brazilian doctors involved in the management of H pylori infection.

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Clinical trial: prolonged beneficial effect of Helicobacter pylori eradication on dyspepsia consultations – the Bristol Helicobacter Project

Cited by 59 publications

References 27 publications

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

ACG Clinical Guideline: Treatment of Helicobacter pylori Infection

Management ofHelicobacter pyloriinfection—the Maastricht V/Florence Consensus Report

3rd BRAZILIAN CONSENSUS ON Helicobacter pylori

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