Ulcers and Gastritis

Once again this year, developments in the field of ulcers and gastritis have been entirely dominated by findings relating to Helicobacter pylori. However, interest in H. pylori can be expected to decline, since the prevalence of the infection is rapidly decreasing in the developing world - to the point that many gastroduodenal ulcers are now unrelated to H. pylori A further reason for declining interest is disappointment regarding the role of H. pylori in dyspepsia. The expected reduction in the endoscopic workload produced by screening for H. pylori or cagA positivity has so far not occurred. The exact role of the damage caused by nonsteroidal anti-inflammatory drugs in H. pylori-infected stomachs remains controversial. Equally controversial is the magnitude of the increased reflux symptomatology and reflux disease observed after H. pylori infection has been cured in patients with ulcer disease. Eradication therapy is largely dominated by proton-pump inhibitor triple therapies, although the efficacy of these is declining. Bismuth triple therapy and quadruple therapy continue to be valid alternatives.

References (Key References are highlighted)

• 1 Blaser  M J. Hypothesis: the changing relationships of Helicobacter pylori and humans: implications for health and disease. .  J Infect Dis. 1999;  179 1523-1530
• 2 Van Doorn L J, Figueiredo C, Sanna R, et al. Clinical relevance of the cagA, vacA, and iceA status of Helicobacter pylori.  Gastroenterology. 1998;  115 58-66
• 3 Van Doorn  L J, Figueiredo C, Mégraud F, et al. Geographic distribution of vacA allelic types of Helicobacter pylori. .  Gastroenterology. 1999;  116 823-830
• 4 Basso D, Navaglia F, Brigato L, et al. Analysis of Helicobacter pylori vacA and cagA genotypes and serum antibody profile in benign and malignant gastroduodenal diseases.  Gut. 1998;  43 182-186
• 5 Rudi J, Rudy A, Maiwald M, et al. Direct determination of Helicobacter pylori vacA genotypes and cagA gene in gastric biopsies and relationship to gastrointestinal diseases.  Am J Gastroenterol. 1999;  94 1525-1531
• 6 Sato T, Fujino M A, Kojima Y, et al. Endoscopic urease sensor system for detecting Helicobacter pylori on gastric mucosa.  Gastrointest Endosc. 1999;  49 32-38
• 7 Gur G, Boyacioglu S, Demirhan B, et al. The importance of increasing the number of gastric biopsies in the diagnosis of Helicobacter pylori.  Hepatogastroenterology. 1998;  45 2219-2223
• 8 Sheu B S, Lin X Z, Yang H B, Chien C H, et al. Cardiac biopsy of stomach may improve the detection of H. pylori after dual therapy.  Hepatogastroenterology. 1999;  46 543-548
• 9 Chey W D, Murthy U, Shaw S, et al. A comparison of three fingerstick, whole blood antibody tests for Helicobacter pylori infection: a United States, multicenter trial.  Am J Gastroenterol. 1999;  94 1512-1516
• 10 Cohen H, Rose S, Lewin D N, et al. Accuracy of four commercially available serologic tests, including two office-based tests and a commercially available ¹³C urea breath test for diagnosis of Helicobacter pylori.  Helicobacter. 1999;  4 49-53
• 11 Asante M A, Mendall M A, Finlayson C, et al. Screening dyspeptic patients for Helicobacter pylori prior to endoscopy: laboratory or near-patient testing?.  Eur J Gastroenterol Hepatol. 1998;  10 843-846
• 12 Chey W D, Murthy U, Toskes P, et al. The ¹³C urea blood test accurately detects active Helicobacter pylori infection: a United States, multicenter trial.  Am J Gastroenterol. 1999;  94 1522-1524
• 13 Cutler A F, Toskes P. Comparison of ¹³C urea blood test to ¹³C urea breath test for the diagnosis of Helicobacter pylori.  Am J Gastroenterol. 1999;  94 959-961
• 14 Breslin N P, Lee J, Buckley M, O'Morian C. Screening for Helicobacter pylori in young dyspeptic patients referred for investigation: endoscopy for those who test negative.  Aliment Pharmacol Ther. 1998;  12 577-582
• 15 Heaney A, Collins J S, Tham T C, et al. A prospective study of the management of the young Helicobacter pylori-negative dyspeptic patient: can gastroscopies be saved in clinical practice?.  Eur J Gastroenterol Hepatol. 1998;  10 953-956
• 16 Asante M A, Mendall M, Patel P, et al. A randomized trial of endoscopy vs. no endoscopy in the management of seronegative Helicobacter pylori dyspepsia.  Eur J Gastroenterol Hepatol. 1998;  10 983-989
• 17 Wiklund I, Glise H, Jerndal P, et al. Does endoscopy have a positive impact on quality of life in dyspepsia?.  Gastrointest Endosc. 1998;  47 449-454
• 18 Laheij R J, Severens J L, Van de Lisdonk E H, et al. Randomized controlled trial of omeprazole or endoscopy in patients with persistent dyspepsia: a cost-effectiveness analysis.  Aliment Pharmacol Ther. 1998;  12 1249-1256
• 19 Nishikawa J, Kawai H, Takahashi A, et al. Seroprevalence of immunoglobulin G antibodies against Helicobacter pylori among endoscopy personnel in Japan.  Gastrointest Endosc. 1998;  48 237-243
• 20 Meineche-Schmidt  V, Christensen E. Classification of dyspepsia: identification of independent symptom components in 7270 consecutive, unselected dyspepsia patients from general practice.  Scand J Gastroenterol. 1998;  33 1262-1272
• 21 Bamfi F, Olivieri A, Arpinelli F, et al. Measuring quality of life in dyspeptic patients - development and validation of a new specific health status questionnaire: final report from the Italian QPD project involving 4000 patients.  Am J Gastroenterol. 1999;  94 730-738
• 22 Talley  N J, Haque M, Wyeth J W. Development of a new dyspepsia impact scale: the Nepean Dyspepsia Index.  Aliment Pharmacol Ther. 1999;  13 225-235
• 23 Rothenbacher D, Peter R, Bode G, et al. Dyspepsia in relation to Helicobacter pylori infection and psychosocial work stress in white collar employees.  Am J Gastroenterol. 1998;  93 1443-1449
• 24 Stone M A, Barnett D B, Mayberry J F, et al. Lack of correlation between self-reported symptoms of dyspepsia and infection with Helicobacter pylori in a general population sample.  Eur J Gastroenterol Hepatol. 1998;  10 301-304
• 25 Blum  A L, Talley N J, O'Morian C, et al. Lack of effect of treating Helicobacter pylori infection in patients with nonulcer dyspepsia (OCAY Study Group). .  New Engl J Med. 1998;  339 1875-1881
• 26 McColl  K, Murray L, El-Omar E, et al. Symptomatic benefit from eradicating Helicobacter pylori infection in patients with nonulcer dyspepsia. .  New Engl J Med. 1998;  339 1869-1874
• 27 Meining A, Kiel G, Stolte M. Changes in Helicobacter pylori-induced gastritis in the antrum and corpus during and after 12 months of treatment with ranitidine and lansoprazole in patients with duodenal ulcer disease.  Aliment Pharmacol Ther. 1998;  12 735-740
• 28 Treiber G, Lambert J R. The impact of Helicobacter pylori eradication on peptic ulcer healing.  Am J Gastroenterol. 1998;  93 1080-1084
• 29 Neil G A, Suchower L J, Johnson E, et al. Helicobacter pylori eradication as a surrogate marker for the reduction of duodenal ulcer recurrence.  Aliment Pharmacol Ther. 1998;  12 619-633
• 30 Macri G, Milani S, Surrenti E, et al. Eradication of Helicobacter pylori reduces the rate of duodenal ulcer rebleeding: a long-term follow-up study.  Am J Gastroenterol. 1998;  93 925-927
• 31 Tu T C, Lee C L, Wu C H, et al. Comparison of invasive and noninvasive tests for detecting Helicobacter pylori infection in bleeding peptic ulcers.  Gastrointest Endosc. 1999;  49 302-306
• 32 Ciociola A A, McSorley D J, Turner K, et al. Helicobacter pylori infection rates in duodenal ulcer patients in the United States may be lower than previously estimated.  Am J Gastroenterol. 1999;  94 1834-1840
• 33 Lee Y T, Sung J J, Choi C L, et al. Ulcer recurrence after gastric surgery: is Helicobacter pylori the culprit?.  Am J Gastroenterol. 1998;  93 928-931
• 34 Iijima K, Ohara S, Sekine H, et al. A new endoscopic method of gastric acid secretory testing.  Am J Gastroenterol. 1998;  93 2113-2118
• 35 Hawkey  C J, Tulassay Z, Szczepanski L, et al. Randomised controlled trial of Helicobacter pylori eradication in patients on non-steroidal anti-inflammatory drugs: HELP NSAIDs study. .  Lancet. 1998;  352 1016-1021
• 36 Chan F K, Sung J J, Suen R, et al. Does eradication of Helicobacter pylori impair healing of nonsteroidal anti-inflammatory drug-associated bleeding peptic ulcers? A prospective randomized study.  Aliment Pharmacol Ther. 1998;  12 1201-1205
• 37 Hawkey C J. Personal review: Helicobacter pylori, NSAIDs and cognitive dissonance.  Aliment Pharmacol Ther. 1999;  13 695-702
• 38 Cryer B, Feldman M. Effects of very low dose daily, long-term aspirin therapy on gastric, duodenal, and rectal prostaglandin levels and on mucosal injury in healthy humans.  Gastroenterology. 1999;  117 17-25
• 39 Konturek J W, Konturek S J, Stachura J, Domschke W. Helicobacter pylori-positive peptic ulcer patients do not adapt to aspirin.  Aliment Pharmacol Ther. 1998;  12 857-864
• 40 Hirschowitz B I, Lanas A. Intractable upper gastrointestinal ulceration due to aspirin in patients who have undergone surgery for peptic ulcer.  Gastroenterology. 1998;  114 883-892
• 41 Lin B R, Shun C T, Wang T H, Lin J T. Endoscopic diagnosis of intestinal metaplasia of stomach: accuracy judged by histology.  Hepatogastroenterology. 1999;  46 162-166
• 42 Driessen A, Ectors N, Creemers J, et al. Intestinal metaplasia in gastric malignancy: a comparison between carcinoma and lymphoma.  Eur J Gastroenterol Hepatol. 1998;  10 595-600
• 43 Chang C S, Chen L T, Yang J C, et al. Isolation of a Helicobacter pylori protein, FldA, associated with mucosa-associated lymphoid tissue lymphoma of the stomach.  Gastroenterology. 1999;  117 82-88
• 44 Lind T, Mégraud F, Unge P, et al. The MACH2 study: role of omeprazole in eradication of Helicobacter pylori with 1-week triple therapies.  Gastroenterology. 1999;  116 248-253
• 45 Malfertheiner P, Bayerdörffer E, Diete U, et al. The GU-MACH study: the effect of 1-week omeprazole triple therapy on Helicobacter pylori infection in patients with gastric ulcer.  Aliment Pharmacol Ther. 1999;  13 703-712
• 46 Levin T R, Schmittdiel J A, Henning J M, et al. A cost analysis of a Helicobacter pylori eradication strategy in a large health maintenance organization.  Am J Gastroenterol. 1998;  93 743-747
• 47 Juul K V, Thomsen O O, Nissen A, et al. National surveillance of Helicobacter pylori eradication therapy in Denmark: results from registration of 34 582 prescriptions.  Scand J Gastroenterol. 1998;  33 928-932
• 48 Stone M A, Patel H, Panja K K, et al. Results of Helicobacter pylori screening and eradication in a multi-ethnic community in central England.  Eur J Gastroenterol Hepatol. 1998;  10 957-962
• 49 Fraser A G, Schreuder V, Chua L E, Moore L. Follow-up after successful eradication of Helicobacter pylori: symptoms and reinfection.  J Gastroenterol Hepatol. 1998;  13 555-559
• 50 Gisbert J P, Pajares J M, Garcia-Valriberas R, et al. Recurrence of Helicobacter pylori infection after eradication: incidence and variables influencing it.  Scand J Gastroenterol. 1998;  33 1144-1151
• 51 Graham D Y, Hepps K S, Ramirez F C, Lew G M, Saeed Z A. Treatment of Helicobacter pylori reduces the rate of rebleeding in peptic ulcer disease.  Scand J Gastroenterol. 1993;  28 939-942
• 52 Rokkas T, Karameris A, Mavrogeorgis A, Rallis E, Giannikos N. Eradication of Helicobacter pylori reduces the possibility of rebleeding in peptic ulcer disease.  Gastrointest Endosc. 1995;  41 1-4
• 53 Santander C, Gravalos R G, Cedenilla A G. Maintenance treatment vs. Helicobacter pylori therapy in preventing rebleeding of the peptic ulcer disease. A clinical trial and follow-up for two years (abstract).  Gastroenterology. 1995;  108 A208
• 54 Labenz J, Borsch G. Role of Helicobacter pylori eradication in the prevention of peptic ulcer bleeding relapse.  Digestion. 1994;  55 19-23
• 55 Jaspersen D, Koerner T, Schorr W, Brennenstuhl M, Raschka C, Hammar C H. Helicobacter pylori eradication reduces the rate of rebleeding in ulcer hemorrhage.  Gastrointest Endosc. 1995;  41 5-7
• 56 Salandin S, Dal Bo N, Grassi S A, Ferrana M, Kusstatscher S, Vianello F, et al. Eradication of H. pylori infection in preventing duodenal ulcer bleeding: one year interim report in a prospective five-year study (abstract).  Gut. 1996;  39 (Suppl. 2) A28
• 57 Macri G, Milani S, Surrenti E, Passaleva M T, Salvadori G, Surrenti C. Eradication of Helicobacter pylori reduces the rate of duodenal ulcer rebleeding: a long-term follow-up study.  Am J Gastroenterol. 1998;  93 925-927
• 58 Pazzi P, Dalla Libera M, La Froscia A, Carli G, Scagliarini R, Merighi A, et al. Helicobacter pylori eradication reduces rebleeding rate in peptic ulcer disease (abstract).  Gastroenterology. 1996;  110 A224
• 59 Sung J J, Leung W K, Suen R, Leung V K, Chan F K, Ling T K, et al. One-week antibiotics versus maintenance acid suppression therapy for Helicobacter pylori-associated peptic ulcer bleeding.  Dig Dis Sci. 1997;  42 2524-2528