Helicobacter pylori Infection

safeinfectious

Description

Gram-negative bacterial infection of the gastric mucosa affecting approximately 50% of the world's population. Major cause of peptic ulcer disease and gastric cancer. Eradication cures most H. pylori-associated ulcers.

Key Features

Often asymptomatic
Causes majority of peptic ulcers
Associated with gastric cancer and MALT lymphoma
Test-and-treat strategy for dyspepsia
14-day triple or quadruple therapy for eradication

Diagnostic Criteria

Indications for H. pylori Testing:
- Active peptic ulcer disease
- History of peptic ulcer (not previously tested)
- Uninvestigated dyspepsia (age < 60, no alarm features)
- Gastric MALT lymphoma
- After endoscopic resection of early gastric cancer
- Long-term NSAID/aspirin use
- Unexplained iron-deficiency anemia
- Idiopathic thrombocytopenic purpura (ITP)
Preferred tests: Urea breath test or stool antigen (stop PPI 2 weeks before)
Confirm eradication: Repeat test ≥ 4 weeks after completing treatment

Red Flags

• Active GI bleeding
• Suspected gastric malignancy
• Treatment failure after 2 courses

Differential Clues

Dyspepsia in younger patientHistory of peptic ulcerFamily history of gastric cancerPositive non-invasive test

Sources: DynaMed. Helicobacter pylori (H. pylori) Infection in Adults. EBSCO Information Services. | ACG Guidelines on H. pylori Treatment 2017 | Maastricht VI Consensus Report