What is the role of the primary care physician in the treatment of Helicobacter pylori infection?

  • P. Malfertheiner
  • T. Breuer


Progress in our knowledge of H. pylori infection has moved on at a relentless pace in basic as well as clinical science. Since H. pylori infection is now known to be the most common cause of chronic gastritis, overwhelming evidence has implicated it as an aetiological factor in a spectrum of gastrointestinal diseases including peptic ulcer, gastric carcinoma and gastric lymphoma1–11. More recently, other non-gastrointestinal diseases, such as coronary heart disease, skin rashes (urticaria) and growth retardation have also been linked with H. pylori infection12. However, these latter associations are still strongly disputed.


Duodenal Ulcer Pylorus Infection Peptic Ulcer Disease Pylorus Eradication Atrophic Gastritis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Correa P, Ruiz B, Hunter F. Clinical trials as etiologic research tools in Helicobacter-associated gastritis. Scand J Gastroenterol Suppl. 1991;181:15–19.PubMedCrossRefGoogle Scholar
  2. 2.
    Parsonnet J, Friedman GD, Vandersteen DP et al. Helicobacter pylori infection and the risk of gastric carcinoma. N Engl J Med. 1991;325:1127–31.PubMedCrossRefGoogle Scholar
  3. 3.
    Parsonnet J, Hansen S, Rodriguez L et al. Helicobacter pylori infection and gastric lymphoma. N Engl J Med. 1994;330:1267–71.PubMedCrossRefGoogle Scholar
  4. 4.
    Nomura A, Stemmermann GN, Chyou PH, Kato I, Perez-Perez Gl, Blaser MJ. Helicobacter pylori infection and gastric carcinoma among Japanese Americans in Hawaii. N Engl J Med. 1991;325: 1132–6.PubMedCrossRefGoogle Scholar
  5. 5.
    Fukao A, Komatsu S, Tsubono Y et al. Helicobacter pylori infection and chronic atrophic gastritis among Japanese blood donors: a cross-sectional study. Cancer Causes Control. 1993;4:307–12.PubMedCrossRefGoogle Scholar
  6. 6.
    Craanen ME, Dekker W, Blok P, Ferwerda J, Tytgat GN. Intestinal metaplasia and Helicobacter pylori: an endoscopic bioptic study of the gastric antrum. Gut. 1992;33:16–20.PubMedCrossRefGoogle Scholar
  7. 7.
    Graham DY, Lew GM, Klein PD et al. Effect of treatment of Helicobacter pylori infection on the long-term recurrence of gastric or duodenal ulcer. A randomized, controlled study. Ann Intern Med. 1992;116:705–8.PubMedGoogle Scholar
  8. 8.
    Graham DY, Hepps KS, Ramirez FC, Lew GM, Saeed ZA. Treatment of Helicobacter pylori reduces the rate of rebleeding in peptic ulcer disease. Scand J Gastroenterol. 1993;28:939–42.PubMedCrossRefGoogle Scholar
  9. 9.
    Bayerdorffer E, Neubauer A, Rudolph B et al. Regression of primary gastric lymphoma of mucosa-associated lymphoid tissue type after cure of Helicobacter pylori infection. MALT Lymphoma Study Group. Lancet. 1995;345:1591–4.PubMedCrossRefGoogle Scholar
  10. 10.
    Stolte M. Helicobacter pylori gastritis and gastric MALT-lymphoma. Lancet. 1992;339:745–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Forman D, Newell DG, Fullerton F et al. Association between infection with Helicobacter pylori and risk of gastric cancer: evidence from a prospective investigation. Br Med J. 1991;302: 1302–5.CrossRefGoogle Scholar
  12. 12.
    Mendall MA, Goggin PM, Molineaux N et al. Relation of Helicobacter pylori infection and coronary heart disease. Br Heart J. 1994;71:437–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Graham DY. Benefits from elimination of Helicobacter pylori infection include major reduction in the incidence of peptic ulcer disease, gastric cancer, and primary gastric lymphoma. Prev Med. 1994;23:712–16.PubMedCrossRefGoogle Scholar
  14. 14.
    Helicobacter pylori in peptic ulcer disease. NIH Consensus Statement. 1994;12:1–23.Google Scholar
  15. 15.
    Forman D, Webb P, Parsonnet J. H. pylori and gastric cancer. Lancet. 1994;343:243–4.PubMedCrossRefGoogle Scholar
  16. 16.
    IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Schistosomes, liver flukes and Helicobacter pylori. Lyon, 7–14 June 1994. IARC Monogr Eval Carcinog Risks Hum. 1994;61:1–241.Google Scholar
  17. 17.
    Kuipers EJ, Lundell L, Klinkenberg Knol EC et al. Atrophic gastritis and Helicobacter pylori infection in patients with reflux oesophagitis treated with omeprazole or fundoplication. N Engl J Med. 1996;334:1018–22.PubMedCrossRefGoogle Scholar
  18. 18.
    Christensen AH, Logan RP, Noach LA, Gjorup T. Do clinicians accept the role of Helicobacter pylori in duodenal ulcer disease: a survey of European gastroenterologists and general practitioners. J Intern Med. 1994;236:501–5.PubMedCrossRefGoogle Scholar
  19. 19.
    Babbs C. H. pylori-associated gastroduodenal disease: survey of British physicians’ views. Gut. 1995;37(Suppl. 1):347 (abstract).Google Scholar
  20. 20.
    Forman D, Milne R, Logan R et al. Attitudes and practices of gastroenterologists in the UK towards Helicobacter pylori disease: results from a large survey. Am J Gastroenterol. 1994;89: 398 (abstract).Google Scholar
  21. 21.
    Penston JG, Mistry KR. Eradication of Helicobacter pylori in general practice. Aliment Pharmacol Ther. 1996;10:139–45.PubMedCrossRefGoogle Scholar
  22. 22.
    Breuer T, Sudhop T, Goodman K et al. Does disease presentation influence treatment of H. pylori infection? A comparison of gastroenterologists and family practitioners. Gastroenterology. 1996; 110(Suppl. 4):A69 (abstract).Google Scholar
  23. 23.
    Breuer T, Sudhop T, Goodman K et al. Treatment regimens used in Helicobacter pylori positive ulcer disease: a comparison of gastroenterologists and family practitioners (abstract). Gastroenterology. 1996;110(Suppl. 4):A69.Google Scholar
  24. 24.
    Breuer T, Sudhop T, Goodman K. Treatment of suspected gastroduodenal ulcer: is the German experience important for health policy decisions in the US? Gastroenterology. 1996; 110(Suppl. 4):A42 (abstract).Google Scholar
  25. 25.
    van der Hulst RW, Keller I J, Rauws EAJ, Tytgat GNJ. Treatment of Helicobacter pylori infection: a review of the world literature. Helicobacter. 1996;1:6–20.PubMedCrossRefGoogle Scholar
  26. 26.
    Patel P, Mendall MA, Lloyd MA, Jazrawi R, Maxwell JD, Northfield TC. Prospective screening of dyspeptic patients by Helicobacter pylori serology. Lancet. 1995;346:1315–18.PubMedCrossRefGoogle Scholar
  27. 27.
    McCarthy C, Patchett S, Collins RM, Beattie S, Keane C, O’Morain C. Long-term prospective study of Helicobacter pylori in nonulcer dyspepsia. Dig Dis Sci. 1995;40:114–19.PubMedCrossRefGoogle Scholar
  28. 28.
    Veldhuyzen van Zanten SJ, Malatjalian DA, Tanton R et al. The effect of eradication of Helicobacter pylori (Hp) on symptoms of non-ulcer dyspepsia (NUD): a randomized double-blind placebo controlled trial. Gastroenterology. 1995;108:A250 (abstract).CrossRefGoogle Scholar
  29. 29.
    Phull PS, Halliday D, Price AB, Jacyna MR. Absence of dyspeptic symptoms as a test for Helicobacter pylori eradication. Br Med J. 1996;312:349–50.Google Scholar

Copyright information

© Kluwer Academic Publishers and Axcan Pharma 1996

Authors and Affiliations

  • P. Malfertheiner
  • T. Breuer

There are no affiliations available

Personalised recommendations