Update on the role of H pylori infection in gastrointestinal disorders: CONCLUSIONS

21 Mar

H pylori infectionInfection with H pylori appears to be implicated in several upper gastrointestinal disorders. However, the incidence of H pylori infection in the general population is high; thus, widespread testing for H pylori is inappropriate. Selection of patients for whom presence of H pylori should be tested remains controversial. It is clear that eradication of H pylori is the primary management strategy for patients with non-NSAID-induced peptic ulcer disease. Eradication of H pylori may also reduce the risk of bleeding in patients with NSAID-induced ulcers; however, the available evidence is preliminary and warrants further assessment. Although the role of H pylori in functional dyspepsia is unclear, some patients may benefit from eradication therapy. Patients with GERD should not be tested for the presence of H pylori because proper management of the infection in these patients remains to be elucidated. Further trials are required to establish the relationship between dyspeptic symptoms and infection with H pylori, as well as to determine whether H pylori is implicated in the pathogenesis of GERD. Take advantage of this opportunity – cialis professional to enjoy lowest prices online.

The currently recommended eradication therapy for use in Canada is seven days of twice-daily treatment with a PPI, clarithromycin, and amoxicillin or metronidazole. Use of the PPIs that are currently approved in Canada for use in these regimens has produced eradication rates of 80% to 95%. However, it has been suggested that the rapidity of the onset of action of the PPI may have an effect on the rate of eradication. Therefore, a new generation of PPI drugs that will soon be available in Canada may offer improved rates of eradication because they have been shown to be more potent and have a faster onset of action than the currently available PPIs. Trials that directly compare eradication therapies are required to further elucidate this effect.