Debate
Antagonist: Should we eradicate Helicobacter pylori before long term antireflux therapy?
J W FrestonUniversity of
Connecticut Health Center, Farmington, Connecticut, USA
Correspondence to: Dr J W Freston, Office of Clinical Research, University of Connecticut Health Center, 263 Farmington Ave, Farmington CT, 06030-1111, USA. Freston@NSO.UCHC.edu
Accepted for publication 5 June 2001
| The first 150 words of the full text of this article appear below. |
 |
Introduction |
|---|
Patient management recommendations that might become
health care policy should be based on the highest level of evidence. The evidence supporting the recommendation to "test and treat" for
Helicobacter pylori infection before
starting long term antireflux treatment falls well short of this
standard. This recommendation arose directly from the report by Kuipers
and colleagues1 in 1996 that the prevalence of corpus
glandular atrophy increased during chronic omeprazole treatment in
patients infected with H pylori. We were
pleased to have another reason to eradicate H
pylori; the prevailing wisdom was that no H
pylori should go unpunished. This aggressive approach has been
challenged, particularly in the case of patients with
gastro-oesophageal reflux disease (GORD). Approximately 42% of adults
in the USA suffer from GORD.2 Nearly 7% experience
heartburn on a daily basis,3 making them potential
candidates for proton pump inhibitor (PPI) therapy and, therefore,
testing for H pylori infection. Apart
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This article has been cited by other articles:
-
Malfertheiner, P
(2004). Helicobacter pylori eradication does not exacerbate gastro-oesophageal reflux disease. Gut
53: 312-313
[Abstract] [Full Text]
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Oesophageal cancer
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Pancreatic cancer
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Campylobacter, Salmonella, Shigella, Escherichia coli
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Helicobacter pylori
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Gastro-oesophageal reflux
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