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Review
. 2014 Mar;29(3):520-8.
doi: 10.1007/s11606-013-2630-y. Epub 2013 Sep 25.

Helicobacter pylori: evidence-based review with a focus on immigrant populations

Derrick Siao  1 , Ma Somsouk
Affiliations
Review

Helicobacter pylori: evidence-based review with a focus on immigrant populations

Derrick Siao et al. J Gen Intern Med. 2014 Mar.

Abstract

Helicobacter pylori has been causally linked to a number of diseases, including peptic ulcer disease, gastric adenocarcinoma, mucosa-associated lymphoid tissue lymphoma, and dyspepsia. It is the most prevalent bacterial pathogen in humans, and while the overall prevalence in the United States is about 30 %, the distribution is heterogeneous amongst different ethnic groups. Recent immigrants from high prevalence areas such as Korea, Japan, and China bear an increased burden of its disease and complications. There is clear evidence that treatment of H. pylori resolves peptic ulcer disease, and increasing evidence for protection against development of gastric adenocarcinoma. However, H. pylori treatment failure is common and alternative regimens may be necessary. The following case-based review will highlight these issues, including the epidemiology of H. pylori in the immigrant population, an approach to dyspepsia, and the role of H. pylori in gastric adenocarcinoma.

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Figures

Figure 1
Figure 1
H. pylori prevalence at age 20 by birth cohort.
Figure 2
Figure 2
Management of Dyspepsia. Adapted from the AGA Medical Position Statement on Dyspepsia. Alarm signs or symptoms include family history of gastric cancer, weight loss, dysphagia/odynophagia, gastrointestinal bleeding, unexplained anemia, or jaundice.
Figure 3
Figure 3
Age-adjusted gastric adenocarcinoma incidence rates by race. Adapted from the Surveillance Epidemiology and End Results (SEER) website http://seer.cancer.gov/faststats/ (last accessed 8/27/13).
See this image and copyright information in PMC

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