Helicobacter pylori-related diseases
Abstract
This article describes the main conclusions drawn from the presentations on Helicobacter pylori infection in Digestive Diseases Week, 2016. Despite the undeniable widespread reduction in the prevalence of this infection, infection rates continue to be high in developing countries. The prevalence of clarithromycin, metronidazole and quinolone resistance is markedly high in most countries and continues to rise. The management of H. pylori infection in patients with peptic ulcers still leaves much to be desired. Although H. pylori eradication reduces the incidence of gastric adenocarcinoma, it does not completely avoid its appearance. The new rapid stool antigen tests show promising results. The efficacy of standard triple therapy is clearly inadequate and continues to decline, and cannot therefore be recommended. Vonoprazan, when associated with 2 antibiotics, is more effective than traditional proton pump inhibitors, especially in clarithromycin-resistant patients. Non-bismuth quadruple (concomitant) therapy achieves eradication rates of around 90% and has a good safety profile. Concomitant therapy is more effective and simpler than sequential therapy. Although some probiotics can increase the efficacy and tolerability of triple therapy, the utility of its association with quadruple concomitant therapy has not been established. If a first treatment with clarithromycin fails, both bismuth-containing quadruple therapy and levofloxacin-containing triple therapy achieve good-but…
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