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Helicobacter pylori gastritis: Difference between revisions
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(Created page with "Infection by H. pylori causes H. pylori gastritis, sometimes called B (bacterial) gastritis or environmental metaplastic atrophic gastritis (EMAG). This is a form of chronic atrophic gastritis and present in a whopping 2/3 of the population worldwide. The prevalence is decreasing due to sanitation and antibiotics, but it is still 90% in developing countries. While the infection usually occurs in childhood in developing countries, it usually occurs in adulthood in industr...") |
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Infection by H. pylori causes H. pylori gastritis, sometimes called B (bacterial) gastritis or environmental metaplastic atrophic gastritis (EMAG). This is a form of chronic atrophic gastritis and present in a whopping 2/3 of the population worldwide. The prevalence is decreasing due to sanitation and antibiotics, but it is still 90% in developing countries. While the infection usually occurs in childhood in developing countries, it usually occurs in adulthood in industrialized countries. | Infection by H. pylori causes '''H. pylori gastritis''', sometimes called '''B (bacterial) gastritis''' or '''environmental metaplastic atrophic gastritis (EMAG)'''. This is a form of chronic [[atrophic gastritis]] and present in a whopping 2/3 of the population worldwide. The prevalence is decreasing due to sanitation and antibiotics, but it is still 90% in developing countries. While the infection usually occurs in childhood in developing countries, it usually occurs in adulthood in industrialized countries. | ||
In most cases, the infection is asymptomatic and lasts the whole life. In those that have symptoms | In most cases, the infection is asymptomatic and lasts the whole life. In those that have symptoms the consequences can however be fatal. The infection gives a 15-20 % lifetime risk of peptic ulcer disease. It has also been linked to 70% of [[Gastric cancer|gastric cancers]], especially intestinal types and gastric <abbr>MALT</abbr> lymphoma. | ||
== Microbiology == | == Microbiology == | ||
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H. pylori gastritis is present in 2/3 of the world’s population. In most cases, the infection is asymptomatic. However, it may cause: | H. pylori gastritis is present in 2/3 of the world’s population. In most cases, the infection is asymptomatic. However, it may cause: | ||
* Atrophic gastritis | * [[Atrophic gastritis]] | ||
* Peptic ulcer disease (especially duodenal ulcers) | * [[Peptic ulcer disease]] (especially duodenal ulcers) | ||
* Gastric cancer | * [[Gastric cancer]] | ||
* Gastric <abbr>MALT</abbr> lymphoma | * Gastric <abbr>MALT</abbr> lymphoma | ||
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* Testing and eradication should be considered | * Testing and eradication should be considered | ||
** Functional dyspepsia | ** Functional dyspepsia | ||
** GERD | ** [[Gastroesophageal reflux disease|GERD]] | ||
** Before long term NSAID therapy | ** Before long term [[NSAID]] therapy | ||
* Testing and eradication not suggested | * Testing and eradication not suggested | ||
** Asymptomatic patients with no high cancer risk close relatives | ** Asymptomatic patients with no high cancer risk close relatives | ||
Eradication is also known as triple therapy, due to the requirement of a combination of three drugs to eradicate the bacterium. The first line is a PPI + clarithromycin + amoxicillin for 14 days. Second line uses metronidazole + tetracycline or levofloxacin + amoxicillin instead. The PPI increases the efficacy of the antibiotics. | Eradication is also known as triple therapy, due to the requirement of a combination of three drugs to eradicate the bacterium. The first line is a [[PPI]] + [[clarithromycin]] + [[amoxicillin]] for 14 days. Second line uses [[metronidazole]] + [[tetracycline]] or [[levofloxacin]] + amoxicillin instead. The PPI increases the efficacy of the antibiotics. | ||
After treatment, eradication should be confirmed by testing, mostly by stool antigen test. If first- and second-line treatments fail the bacterium should be cultured for antibiotic resistance. Antibiotic resistance is an increasing problem with regards to H. pylori. First line antibiotics may differ geographically based on local resistance rates. | After treatment, eradication should be confirmed by testing, mostly by stool antigen test. If first- and second-line treatments fail the bacterium should be cultured for antibiotic resistance. Antibiotic resistance is an increasing problem with regards to H. pylori. First line antibiotics may differ geographically based on local resistance rates. | ||
[[Category:Gastroenterology]] | [[Category:Gastroenterology]] | ||