Current concepts in the management of Helicobacter pylori infection: the maastricht III consensus report

• Type: Article in International Scientific Journal
• Date: 2007

Authors

Malfertheiner, P (Author) Other; Megraud, F (Author) Other; O¿Morain, C (Author) Other; Bazzoli, F (Author) Other; El Omar, E (Author) Other; Graham, D (Author) Other; Hunt, R (Author) Other; Rokkas, T (Author) Other; Vakil, N (Author) Other; Kuipers, EJ (Author) Other; Andersen, L (Author) Other; Atherton, J (Author) Other; Asaka, M (Author) Other; Bazzoli, F (Author) Other; Bytzer, P (Author) Other; Chan, F (Author) Other; Coelho, LGV (Author) Other; De Wit, N (Author) Other; Delchier, JC (Author) Other; Di Mario, F (Author) Other; El Omar, E (Author) Other; Fock, KM (Author) Other; Forman, D (Author) Other; Fujioka, T (Author) Other; Gasbarrini, G (Author) Other; Genta, R (Author) Other; Goh, KL (Author) Other; Graham, DY (Author) Other; Hirschl, A (Author) Other; Hungin, P (Author) Other; Hunt, R (Author) Other; Isakov, VA (Author) Other; Jones, R (Author) Other; Kist, M (Author) Other; Koletzko, S (Author) Other; Kuipers, EJ (Author) Other; Kupcinskas, L (Author) Other; Ladas, S (Author) Other; Lanas, A (Author) Other; Machado JC (Author) FMUP; Malfertheiner, P (Author) Other; McColl, KEL (Author) Other; Mégraud, F (Author) Other; Michetti, P (Author) Other; Moayyedi, P (Author) Other; Omorain, C (Author) Other; Pilotto, A (Author) Other; Quina, M (Author) Other; Rokkas, T (Author) Other; Sharma, P (Author) Other; Simsek, Y (Author) Other; Sipponen, P (Author) Other; Sollano, J (Author) Other; Stockbrügger, R (Author) Other; Sugano, K (Author) Other; Vaira, D (Author) Other; Vakil, N (Author) Other; Vieth, M (Author) Other; Xiao, S (Author) Other

Journal

Title: Gut

Vol. 56

Pages: 772-781

ISSN: 0017-5749

Publisher: BMJ PUBLISHING GROUP

Indexing

ISI Web of Knowledge - 1387 Citations

Scopus - 1726 Citations

Other information

Authenticus ID: P-00K-VB2

DOI: 10.1136/gut.2006.101634

Abstract (EN): Background: Guidelines on the management of Helicobacter pylori, 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 pylori eradication for the prevention of gastric cancer. Results: Eradication of H pylori 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; (d) 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 pylori infection (a) does not cause gastro-oesophageal reflux disease (GORD) or exacerbate GORD, and (b) may prevent peptic ulcer in patients who are naive users of non-steroidal antiinflammatory drugs (NSAIDs). H pylori 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 pylori 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 pylori infection has the potential to reduce the risk of gastric cancer development.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 10