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The infection always cause a gastric inflammation that may develop into peptic ulcer disease or gastric cancer. Umeå university helicobacter pylori infection is acquired in child hood amp plays a causative role in peptic ulcer disease, chronic gastritis, amp in the gastric cancer development. Many treatment regimes have been developed to effectively treat this infection since early 1980s.

International guidelines have allowed consensus on the best management amp improved eradication rates. Increasing antimicrobial resistance has resulted in falling eradication rates with st amp ard therapies during recent years. Here we review the guidelines amp most recent studies in the treatment of helicobacter pylori. Presently, the ﬁrst line treatment remains clarithromycin, amoxicillin or metronidazole amp proton pump inhibitor twice daily, but a number of recent studies have shown low eradication rates with this treatment. Increased duration of therapy has been recommended to overcome the falling eradication rates. However, conﬂicting ﬁndings have been reported on the beneﬁts of extending the length of traditional therapy. Sequential therapy may be an effective alternative to st amp ard triple therapy in regions of increased antimicrobial resistance.

Side effects from traditional regimens is reduced by probiotics amp may improve eradication rates. A quinolone based second line triple therapy appears to be effective amp well tolerated. In the future, regional antimicrobial resistance amp eradication rates will determine the best treatment for h. Pylori infection with emphasis on both indications for treatment amp eradication regimens amp co therapy.

Pylori are a type of intestinal bacteria that cause the majority of ulcers in the stomach amp duodenum. They thrive in highly acidic environments amp have a unique way of adapting to the harsh environment of the stomach. Pylori have been classified as low potential carcinogens cancer causing substances by the world health organization.

Pylori positive subjects have chronic active gastritis, it is estimated that only 20–25% of affected subjects develop clinically overt disease during their lifetime.1 this ranges from gastric amp duodenal ulcer disease to gastric adenocarcinoma amp lymphoma, as well as more rare disorders, including a few extra gastric disorders. Pylori eradication has a major impact on the natural course of several of these disorders, in particular peptic ulcer disease amp gastric mucosa associated lymphoid tissue malt lymphoma. The recognition of this effect amp the development of effective treatment strategies have revolutionized the clinical approach to these patients. This is generally considered one of the most important new developments in gastroenterology in the past 25 years, which was supported by the award of the nobel prize to drs marshall amp warren, who first recognized the clinical importance of this bacterium.2 ever since then, much effort has been spent on developing optimal treatment strategies for the clinical management of h. The evidence that h pylori infection causes peptic ulcer disease is compelling 3–5 thus however, currently, the level of evidence supporting an association between specific symptoms due to h pylori infection in children amp recurrent abdominal pain is insufficient to advocate testing amp treating in this clinical context 6.

Furthermore, a similar prevalence of h pylori infection in children with amp without functional abdominal pain was identified in case control trials 7 unfortunately the reported treatment trials that lack controls do not provide additional supportive information. Although current guidelines for adults advocate a test amp treat strategy, when nonnuclear dyspepsia treatment trials were assessed systematically, h pylori eradication had only a small effect on dyspeptic symptoms once the role of h. Pylori in peptic ulcer disease was firmly established, it was imperative to find out more about the prevalence amp distribution of the infection.

To do this, investigators needed data about large populations of people all over the world amp a way to make feasible such extensive testing. Not only were specialized equipment amp techniques necessary to grow the bacteria, but also the only way to obtain culture material from human sources was by endoscopy, hardly feasible for large scale studies. Pylori antibodies could be detected in the blood serum of individuals who were infected with the organism. That enabled the use of a simple blood test for the important epidemiological studies. Researchers were able to expedite the investigations because they did not have to collect new tissue samples from each person instead, they used blood samples that had already been collected in large numbers at clinics amp blood banks, often for other studies amp tests.

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It showed that h.pylori is a common bacterial agent amp at least 30 50% of the world’s population are colonized with it. Pylori presentation was highly variable from country to country amp between socioeconomic amp ethnic groups. Overall, they found a consistent pattern in most developing nations, where 70 to 90% of adults harbored the bacteria most individuals acquired the infection as children, before age 10. In developed countries, on the other h amp , fewer than 10% of children became infected amp although a steady rate of colonization persisted with increasing age, less than half of 60 year olds had acquired h. Clear associations could be made with conditions of poor sanitation amp crowded living conditions such as those in orphanages or other institutions. In spite of this connection with the signs associated with poverty, the studies failed to establish whether or how transmission from one individual to another actually occurs. But aside from minor modes of passage, such as through unsterilized endoscopy equipment amp from african mothers who premasticate food for their children, researchers have been unable to identify a common means for transferring the infection from person to person.

A surprising finding was that most infected individuals were generally asymptomatic amp fewer than 20% of people regardless of age who tested positive for h. Pylori infection is nothing like catching a common cold in that immediate consequences of an infection are rarely seen. This discomfort is usually a dull, gnawing ache that comes amp goes for several days or weeks. It usually occurs two to three hours after a meal or in the middle of the night when the stomach is empty amp is relieved by eating, drinking milk or taking antacid medications.

Other symptoms include: heartburn, increased burping, weight loss, bloating amp burping, amp less common symptoms include: poor appetite, nausea amp vomiting. Most people recover from their symptoms within two to three weeks of starting antibiotic therapy. Severe symptoms associated with serious ulcer related problems may take longer to heal. Pylori bacteria have been associated with many different diseases, including: duodenal ulcers, gastric stomach ulcers, stomach cancer amp non ulcer dyspepsia indigestion. Pylori infections have also been linked with causing gastritis inflammation of the stomach in adults amp children. Infected persons have a two to six fold increased risk of developing stomach cancer amp lymphoma cancerous tumors in the lymphatic tissue compared with their uninfected equivalents. If an ulcer does cause bleeding, prolonged bleeding may cause anemia leading to weakness amp fatigue.

If bleeding is heavy, hematemesis the vomiting of blood , hematochezia the passage of feces containing blood , or melena a condition marked by black, tarry stools or vomit composed largely of blood may occur. Pylori infection should only be diagnosed when an eradicating therapy is indicated. The discussion has considered two viewpoints regarding diagnostic modalities for h. Pylori infection: on the one h amp , the diagnostic method to use in varying clinical situations on the other h amp , the current role of each individual diagnostic modality. Regarding diagnosis, agreed upon recommendations for the following clinical settings will be discussed: a endoscopic diagnosis of normality amp dyspepsia symptoms. Regarding diagnostic modalities, consensus has been reached on the current role of methods based on: endoscopy test biopsy collection histology, rapid urease test, amp culture an endoscopy diagnoses an h.

Dissertation H Helicobacter Infection Pylori Text

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