A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication

World J Gastroenterol. 2014 Feb 14;20(6):1438-49. doi: 10.3748/wjg.v20.i6.1438.

Abstract

Helicobacter pylori (H. pylori) affects nearly half of the world's population and, thus, is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with peptic ulcer disease, gastric ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Various diagnostic methods exist to detect infection, and the choice of one method or another depends on several factors, such as accessibility, advantages and disadvantages of each method, cost, and the age of patients. Once H. pylori infection is diagnosed, the clinician decides whether treatment is necessity, according to the patient's clinical condition. Typically, eradication of H. pylori is recommended for treatment and prevention of the infection. Cure rates with the standard triple therapy are acceptable, and effective quadruple therapies, sequential therapies, and concomitant therapies have been introduced as key alternatives to treat H. pylori infection. In this work, we review the main diagnostic methods used to identify H. pylori infection and to confirm eradication of infection. In addition, key factors related to treatment are reviewed.

Keywords: Concomitant therapy; Diagnosis; Helicobacter pylori; Hybrid therapy; Sequential therapy; Treatment.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Biopsy
  • Breath Tests
  • Clarithromycin / pharmacology
  • Drug Resistance, Bacterial
  • Helicobacter Infections / diagnosis*
  • Helicobacter Infections / drug therapy*
  • Helicobacter Infections / microbiology*
  • Helicobacter pylori / drug effects*
  • Humans
  • Lymphoma, B-Cell, Marginal Zone / microbiology
  • Peptic Ulcer / microbiology
  • Probiotics / therapeutic use
  • Reproducibility of Results
  • Stomach Neoplasms / microbiology
  • Stomach Ulcer / microbiology
  • Treatment Outcome
  • Urea / metabolism
  • Urease / metabolism

Substances

  • Anti-Bacterial Agents
  • Urea
  • Urease
  • Clarithromycin