Management of Helicobacter pylori Infection: What Should the Surgeon Know?

Abstract

Infection with Helicobacter pylori continues to represent a major global health care burden, and various national and international consensus reports and guidelines have aimed at tracking recent developments for their translation into an optimized clinical management. The most important 'innovation' is the definition of H. pylori gastritis as an infectious disease. This does imply the consideration of therapy of this condition even before the development of clinical manifestations including non-malignant and malignant gastroduodenal diseases, such as peptic ulcer disease, gastric cancer, and gastric mucosa-associated lymphoid tissue lymphoma. Treatment of H. pylori is facing an increasing number of failures, with the main reason being an increasing antibiotic resistance to some of the previously most effective antibiotics, i.e. clarithromycin and levofloxacin, for H. pylori strains. Several new treatment options or modifications of already established regimens have been introduced to overcome bacterial resistance and treatment failure. In this review, we provide an update on the current recommendations for a successful management of H. pylori infection, and in this context a special reference is made to the role of visceral surgeons.

Keywords: Diagnosis; Helicobacter pylori; Treatment.

Fig. 1

Treatment algorithm based on the German guideline. *Risk factors: country of origin, pretreatment with macrolides.