Article Text

Kyoto global consensus report on Helicobacter pylori gastritis
  1. Kentaro Sugano1,
  2. Jan Tack2,
  3. Ernst J Kuipers3,
  4. David Y Graham4,
  5. Emad M El-Omar5,
  6. Soichiro Miura6,
  7. Ken Haruma7,
  8. Masahiro Asaka8,
  9. Naomi Uemura9,
  10. Peter Malfertheiner10
  11. on behalf of faculty members of Kyoto Global Consensus Conference
    1. 1Department of Medicine, Jichi Medical University, Tochigi, Japan
    2. 2Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium
    3. 3Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherland
    4. 4Department of Medicine, Michael E DeBakery VA Medical Center, Baylor College of Medicine, Houston, USA
    5. 5Division of Applied Medicine, Institute of Medical Sciences, Aberdeen University, Aberdeen, UK
    6. 6National Defense Medical College, Tokorozawa, Japan
    7. 7Department of Gastroenterology, Kawasaki Medical School, Kurashiki, Japan
    8. 8Department of Cancer Preventive Medicine, Hokkaido University, Sapporo, Japan
    9. 9Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
    10. 10Department of Gastroenterology, University of Magdeburg, Magdeburg, Germany
    1. Correspondence to Professor Kentaro Sugano, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan; sugano{at}


    Objective To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate diagnostic assessment of gastritis and (4) when, whom and how to treat H. pylori gastritis.

    Design Twenty-three clinical questions addressing the above-mentioned four domains were drafted for which expert panels were asked to formulate relevant statements. A Delphi method using an anonymous electronic system was adopted to develop the consensus, the level of which was predefined as ≥80%. Final modifications of clinical questions and consensus were achieved at the face-to-face meeting in Kyoto.

    Results All 24 statements for 22 clinical questions after extensive modifications and omission of one clinical question were achieved with a consensus level of >80%. To better organise classification of gastritis and duodenitis based on aetiology, a new classification of gastritis and duodenitis is recommended for the 11th international classification. A new category of H. pylori-associated dyspepsia together with a diagnostic algorithm was proposed. The adoption of grading systems for gastric cancer risk stratification, and modern image-enhancing endoscopy for the diagnosis of gastritis, were recommended. Treatment to eradicate H. pylori infection before preneoplastic changes develop, if feasible, was recommended to minimise the risk of more serious complications of the infection.

    Conclusions A global consensus for gastritis was developed for the first time, which will be the basis for an international classification system and for further research on the subject.


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