Management of Helicobacter pylori infection
Abstract Helicobacter pylori infection exhibits a wide disease spectrum ranging from asymptomatic gastritis, peptic ulcer disease, to gastric cancer. H. pylori can induce dysbiosis of gastric microbiota in the pathway of carcinogenesis and successful eradication can restore gastric homeostasis. Diag...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | JGH Open |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jgh3.12843 |
| _version_ | 1811177055780339712 |
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| author | Natsuda Aumpan Varocha Mahachai Ratha‐korn Vilaichone |
| author_facet | Natsuda Aumpan Varocha Mahachai Ratha‐korn Vilaichone |
| author_sort | Natsuda Aumpan |
| collection | DOAJ |
| description | Abstract Helicobacter pylori infection exhibits a wide disease spectrum ranging from asymptomatic gastritis, peptic ulcer disease, to gastric cancer. H. pylori can induce dysbiosis of gastric microbiota in the pathway of carcinogenesis and successful eradication can restore gastric homeostasis. Diagnostic testing and treatment for H. pylori infection is recommended in patients with active or past history of peptic ulcer, chronic dyspepsia, chronic non‐steroidal anti‐inflammatory drugs (NSAID) or aspirin use, precancerous gastric lesions, gastric cancer, mucosa‐associated lymphoid tissue (MALT) lymphoma, family history of gastric cancer, family history of peptic ulcers, household family member having active H. pylori infection, iron deficiency anemia, idiopathic thrombocytopenic purpura, or vitamin B12 deficiency. Recommended first‐line regimens for H. pylori eradication are classified according to clarithromycin resistance. In areas of high clarithromycin resistance (≥15%), we recommend 14‐day concomitant therapy or 14‐day bismuth quadruple therapy (BQT) as first‐line regimen. In areas of low clarithromycin resistance (<15%), we recommend 14‐day triple therapy or 14‐day BQT as first‐line treatment. Second‐line regimens are 14‐day levofloxacin triple therapy or 14‐day BQT if BQT is not previously used. For patients with multiple treatment failure, antimicrobial susceptibility testing (AST) should be performed. If AST is not available, we recommend using antibiotics not previously used or for which resistance is unlikely, such as amoxicillin, tetracycline, bismuth, or furazolidone. High‐dose potent proton pump inhibitor or vonoprazan is recommended to achieve adequate acid suppression. Probiotics can be used as an adjuvant treatment to reduce the side effects of antibiotics and enhance eradication rate. |
| first_indexed | 2024-04-10T22:55:37Z |
| format | Article |
| id | doaj.art-383d3f67fa64422b81210de6475311e6 |
| institution | Directory Open Access Journal |
| issn | 2397-9070 |
| language | English |
| last_indexed | 2024-04-10T22:55:37Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | JGH Open |
| spelling | doaj.art-383d3f67fa64422b81210de6475311e62023-01-14T11:33:19ZengWileyJGH Open2397-90702023-01-017131510.1002/jgh3.12843Management of Helicobacter pylori infectionNatsuda Aumpan0Varocha Mahachai1Ratha‐korn Vilaichone2Center of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine Thammasat University Pathumthani ThailandCenter of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine Thammasat University Pathumthani ThailandCenter of Excellence in Digestive Diseases and Gastroenterology Unit, Department of Medicine Thammasat University Pathumthani ThailandAbstract Helicobacter pylori infection exhibits a wide disease spectrum ranging from asymptomatic gastritis, peptic ulcer disease, to gastric cancer. H. pylori can induce dysbiosis of gastric microbiota in the pathway of carcinogenesis and successful eradication can restore gastric homeostasis. Diagnostic testing and treatment for H. pylori infection is recommended in patients with active or past history of peptic ulcer, chronic dyspepsia, chronic non‐steroidal anti‐inflammatory drugs (NSAID) or aspirin use, precancerous gastric lesions, gastric cancer, mucosa‐associated lymphoid tissue (MALT) lymphoma, family history of gastric cancer, family history of peptic ulcers, household family member having active H. pylori infection, iron deficiency anemia, idiopathic thrombocytopenic purpura, or vitamin B12 deficiency. Recommended first‐line regimens for H. pylori eradication are classified according to clarithromycin resistance. In areas of high clarithromycin resistance (≥15%), we recommend 14‐day concomitant therapy or 14‐day bismuth quadruple therapy (BQT) as first‐line regimen. In areas of low clarithromycin resistance (<15%), we recommend 14‐day triple therapy or 14‐day BQT as first‐line treatment. Second‐line regimens are 14‐day levofloxacin triple therapy or 14‐day BQT if BQT is not previously used. For patients with multiple treatment failure, antimicrobial susceptibility testing (AST) should be performed. If AST is not available, we recommend using antibiotics not previously used or for which resistance is unlikely, such as amoxicillin, tetracycline, bismuth, or furazolidone. High‐dose potent proton pump inhibitor or vonoprazan is recommended to achieve adequate acid suppression. Probiotics can be used as an adjuvant treatment to reduce the side effects of antibiotics and enhance eradication rate.https://doi.org/10.1002/jgh3.12843Helicobacter pylorimanagementtreatment |
| spellingShingle | Natsuda Aumpan Varocha Mahachai Ratha‐korn Vilaichone Management of Helicobacter pylori infection JGH Open Helicobacter pylori management treatment |
| title | Management of Helicobacter pylori infection |
| title_full | Management of Helicobacter pylori infection |
| title_fullStr | Management of Helicobacter pylori infection |
| title_full_unstemmed | Management of Helicobacter pylori infection |
| title_short | Management of Helicobacter pylori infection |
| title_sort | management of helicobacter pylori infection |
| topic | Helicobacter pylori management treatment |
| url | https://doi.org/10.1002/jgh3.12843 |
| work_keys_str_mv | AT natsudaaumpan managementofhelicobacterpyloriinfection AT varochamahachai managementofhelicobacterpyloriinfection AT rathakornvilaichone managementofhelicobacterpyloriinfection |