Hong Kong Med J 1999;5:151-7 | Number 2, June 1999
Who should be treated for Helicobacter pylori infection?
CK Ching, BCY Wong
Room 605, Manning House, 48 Quuen's Road Central, Hong Kong
Helicobacter pylori infection affects approximately half of the world's population. In Hong Kong, approximately 55% of the population is infected with this organism. But symptoms and clinical disease develop in only a minority of infected individuals during their lifetime. Treatment should thus be appropriately targeted. It is imperative that infected patients who have either a current or past history of peptic ulcer disease, with or without bleeding or a perforation complication, and those with low-grade gastric, mucosal-associated lymphoid tissue lymphoma should all have the organism eliminated. There is evidence that anti-Helicobacter pylori therapy reduces the recurrence of gastric cancer after the successful removal of early gastric cancer lesions. Patients with non-ulcer dyspepsia, particularly those with severe symptoms, should also be considered for a trial of eradication therapy. Whether or not eradication therapy should be given to those who require long-term non-steroidal anti-inflammatory drug therapy, but who do not have a history of peptic ulcer disease is still not decided. The use of prophylactic eradication to stop the development of gastric cancer or peptic ulceration in H pylori--positive but asymptomatic individuals should be considered only in research settings.
Key words: Dyspepsia/drug therapy; Helicobacter infections/therapy; Helicobacter pylori; Peptic ulcer/drug therapy; Stomach neoplasms
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