| [ Summary ] |
It has been suggested that infection with Helicobacter pylori (H.pylori) causes gastritis in almost all the patients, but usually does not cause malignant diseases, such as gastric carcinoma or malignant lymphoma. Several recent studies, however, have demonstrated that gastric carcinoma is strongly associated with H.pylori infection. Therefore, one would expect that all kinds of H.pylori, including those in gastritis patients, should be eradicated to prevent subsequent development of gastric carcinoma. There remains, however, several unsolved issues before starting complete eradication of H.pylori from all the H.pylori-infected human being in the world. First, we do not know whether H.pylori is the most important carcinogen with regard to gastric cancer. In addition, we do not know how much we can reduce the risk of gastric carcinoma through eradication of H.pylori in adult patients, who have already been infected with H.pylori presumably for more than 20 years. Second, it seems possible that H.pylori eradication raises the risk of adenocarcinoma of the esophagus, in contrast to its beneficial effects on lowering risk of the gastric carcinoma. Third, it seems highly likely that H.pylori eradication in large number of the population increases the number of H.pylori strains, which show resistance to almost all antibiotics. Increase in such antibiotic-resistant H.pylori strains may provoke more harmful effects on our gastric mucosae. Based on these standpoints, it seems too early to conclude that all the H.pylori should be eradicated merely for the prevention of gastric carcinoma. |