Diagnosis and treatment of Helicobacter: a 2002 updated review

Abstract

Summary The year 2002 saw advances on many fronts in the study of Helicobacter and gastroduodenal disease. Several studies have confirmed endoscopy as a valuable management procedure with confirmation of the diagnostic utility of the rapid urease test and the description of a new formulation of the test, which is more rapid in giving a result. Serology has been re‐confirmed as a useful investigation in selected populations. Some commercial kits for near patient testing have also been assessed and although generally regarded as less accurate than laboratory based tests some have shown acceptable accuracy. The recent exciting development in diagnostic serology is the availability of the faecal antigen test; further studies have confirmed its usefulness as recommended screening tests. There have been several studies demonstrating that a test and treat policy has a significant patient benefit, both economic and medical, although there is some doubt if eradication of Helicobacter leads to regression of atrophy and metaplasia. However, in low Helicobacter‐prevalence areas the test and treat policy is being challenged as an effective management strategy. Further studies have shown that compliance with treatment regimens is an important determinant of successful eradication. Finally several new eradication regimens have been reported particularly for use in patients who have had previous unsuccessful eradication attempts.

Comparison of the Diagnostic Accuracy of Five Different Stool Antigen Tests for the Diagnosis of Helicobacter pylori Infection

“…This test is convenient for patients and can be easily performed in small laboratories. The UBT has been included in several clinical guidelines as a recommended noninvasive test in dyspeptic patients [7][8][9][10]. However, few studies have compared the new monoclonal HpSA tests, and major differences in the diagnostic accuracy have been observed [11][12][13][14][15].…”

Development of an immunochromatographic lateral flow device for rapid detection of Helicobacter pylori stool antigen

“…Among the non-invasive tests, the HpSA test has attracted special attention due to its extreme convenience and the ability to distinguish patients with active infection from those with only H. pylori infection history [22,23]. The HpSA test was first introduced with polyclonal antibodies [24]. This explains the discrepant results in early reports, since the difference from batch to batch of polyclonal antibodies is Table 3 Testing results of different bacterial strains.…”

Preliminary Pages / Contents / Preface to the Updated Reprint / Foreword / Preface

“…The most relevant ones, of which a critical update has been recently published [5], were produced by the European Helicobacter pylori Study Group [6] during the second Maastricht Consensus Meeting in September 2000. Besides the controversy surrounding the indications for eradication, the real novelties in the field of therapy of Helicobacter infection have been the introduction of esomeprazole-based eradication regimens as well as the development of some effective rescue therapies [7]. This is why, when the publisher informed us of his willingness to reprint this book due to the success encountered, we decided to include three new chapters dealing with the above topics in the hope to complement its contents and offer the readers the most recent information.…”