Academic Journal

Current concepts in the management of Helicobacter pylon infection: the Maastricht III Consensus Report.

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Τίτλος: Current concepts in the management of Helicobacter pylon infection: the Maastricht III Consensus Report.
Συγγραφείς: Malfertheiner, P., Megraud, F., O'Morain, C., Bazzoli, F., El-Omar, E., Graham, D., Hunt, R., Rokkas, I., Vakil, N., Kuipers, E. J.
Πηγή: Gut (0017-5749); Jun2007, Vol. 56 Issue 6, p772-781, 10p, 6 Charts
Θεματικοί όροι: Helicobacter pylori, Helicobacter diseases, Stomach cancer, Peptic ulcer, Gastritis, Thrombopenic purpura, Gastric mucosa, Abdominal pain
Περίληψη: Background: Guidelines on the management of Helicobacterpylori, which cover indications for management and treatment strategies, were produced in 2000. Aims: To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylon eradication for the prevention of gastric cancer. Results: Eradication of H pylon infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (c) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a ‘test and treat’ strategy if other causes are excluded. Eradication of H pylon infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal anti-inflammatory drugs (NSAIDs). H pylon eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a non-invasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylon infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. Conclusion: The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylon infection has the potential to reduce the risk of gastric cancer development. [ABSTRACT FROM AUTHOR]
Copyright of Gut (0017-5749) is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Βάση Δεδομένων: Complementary Index
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  Data: Current concepts in the management of Helicobacter pylon infection: the Maastricht III Consensus Report.
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  Data: <searchLink fieldCode="DE" term="%22Helicobacter+pylori%22">Helicobacter pylori</searchLink><br /><searchLink fieldCode="DE" term="%22Helicobacter+diseases%22">Helicobacter diseases</searchLink><br /><searchLink fieldCode="DE" term="%22Stomach+cancer%22">Stomach cancer</searchLink><br /><searchLink fieldCode="DE" term="%22Peptic+ulcer%22">Peptic ulcer</searchLink><br /><searchLink fieldCode="DE" term="%22Gastritis%22">Gastritis</searchLink><br /><searchLink fieldCode="DE" term="%22Thrombopenic+purpura%22">Thrombopenic purpura</searchLink><br /><searchLink fieldCode="DE" term="%22Gastric+mucosa%22">Gastric mucosa</searchLink><br /><searchLink fieldCode="DE" term="%22Abdominal+pain%22">Abdominal pain</searchLink>
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  Data: Background: Guidelines on the management of Helicobacterpylori, which cover indications for management and treatment strategies, were produced in 2000. Aims: To update the guidelines at the European Helicobacter Study Group (EHSG) Third Maastricht Consensus Conference, with emphasis on the potential of H pylon eradication for the prevention of gastric cancer. Results: Eradication of H pylon infection is recommended in (a) patients with gastroduodenal diseases such as peptic ulcer disease and low grade gastric, mucosa associated lymphoid tissue (MALT) lymphoma; (b) patients with atrophic gastritis; (c) first degree relatives of patients with gastric cancer; (c) patients with unexplained iron deficiency anaemia; and (e) patients with chronic idiopathic thrombocytopenic purpura. Recurrent abdominal pain in children is not an indication for a ‘test and treat’ strategy if other causes are excluded. Eradication of H pylon infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naïve users of non-steroidal anti-inflammatory drugs (NSAIDs). H pylon eradication is less effective than proton pump inhibitor (PPI) treatment in preventing ulcer recurrence in long term NSAID users. In primary care a test and treat strategy using a non-invasive test is recommended in adult patients with persistent dyspepsia under the age of 45. The urea breath test, stool antigen tests, and serological kits with a high accuracy are non-invasive tests which should be used for the diagnosis of H pylon infection. Triple therapy using a PPI with clarithromycin and amoxicillin or metronidazole given twice daily remains the recommended first choice treatment. Bismuth-containing quadruple therapy, if available, is also a first choice treatment option. Rescue treatment should be based on antimicrobial susceptibility. Conclusion: The global burden of gastric cancer is considerable but varies geographically. Eradication of H pylon infection has the potential to reduce the risk of gastric cancer development. [ABSTRACT FROM AUTHOR]
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  Label:
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  Data: <i>Copyright of Gut (0017-5749) is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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