Helicobacter pylori and non‐malignant upper gastrointestinal diseases

Abstract

Peptic ulcer disease (PUD) has been further decreased over the last decades along with decreasing prevalence of Helicobacter pylori-associated PUD. A delayed H. pylori eradication has been associated with an increased risk of rehospitalization for complicated recurrent peptic ulcer and reemphasized the importance of eradication especially in patients with peptic ulcer bleeding (PUB). PUB associated with NSAID/aspirin intake and H. pylori revealed an additive interaction in gastric pathophysiology which favors the "test-and-treat" strategy for H. pylori in patients with specific risk factors. The H. pylori-negative and NSAID-negative "idiopathic PUD" have been increasingly observed and associated with slower healing tendency, higher risk of recurrence, and greater mortality. Helicobacter pylori-associated dyspepsia has been further investigated and finally defined by the Kyoto consensus. Helicobacter pylori eradication therapy is advised as first option in this group of patients. Only in the case of symptom persistence or recurrence after eradication therapy, dyspeptic patients should be classified as functional dyspepsia (FD). There were few new data in 2015 on the role of H. pylori infection in gastroesophageal reflux disease (GERD), and in particular Barrett's esophagus. A lower prevalence of gastric atrophy with less acid output in patients with erosive esophagitis confirmed previous findings. In patients with erosive esophagitis, no difference was observed in healing rates neither between H. pylori-positive and H. pylori-negative patients nor between patients that underwent eradication therapy compared to patients without eradication. These findings are in line with the current consensus guidelines concluding that H. pylori eradication has no effects on symptoms and does not aggravate preexisting GERD.

Ivth Brazilian Consensus Conference on Helicobacter Pylori Infection

“…The studies that sought to evaluate the association between HP, BE, and ADE found a high variability in the methods, selection bias, and characterization of the study population (199,200) . A meta-analysis reported that the relative risk of BE in patients with HP infection was 0.46 (0.35-0.60); i.e., there was a strong negative association between HP and BE (201) .…”

Doenças relacionadas à infecção pelo Helicobacter pylori

“…Os principais processos neoplásicos envolvem o adenorcarcinoma e o linfoma MALT (Mucosa Associated Lymphoid Tissue), formas histológicas mais frequentes encontradas na parede gástrica 4,9,10 .…”

Complete symptom resolution as predictor of Helicobacter pylori eradication and factors affecting symptom resolution: Prospective follow up study

“…Upper gastrointestinal dyspepsia symptoms originated from H. pylori infection has been classified as non-functional organic disorders [8] to differentiate it from functional dyspepsia which shows symptom persistence or recurrence after eradication [9]. Symptoms of upper gastrointestinal disorder that occur commonly include intermittent or persistent pain or discomfort in the upper abdomen or lower part of the chest, heartburn, nausea, and a feeling of postprandial fullness, whereas less common symptoms include vomiting, diarrhea, belching, and headache [10][11][12].…”