| Theme | Helicobacter pylori update | |
|---|---|---|
| Title | The Revision of Guidelines for Diagnosis and the Treatment of Helicobacter pylori Infection | |
| Publish Date | 2005/01 | |
| Author | Mototsugu Kato | Division of Endoscopy, Hokkaido University Hospital |
| Author | Souichi Nakagawa | Division of Endoscopy, Hokkaido University Hospital |
| Author | Yuichi Shimizu | Division of Endoscopy, Hokkaido University Hospital |
| Author | Yasuaki Mori | Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| Author | Shouko Ono | Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| Author | Yuji Ono | Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| Author | Manabu Nakagawa | Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| Author | Junji Yamamoto | Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| Author | Masahiro Asaka | Department of Gastroenterology, Hokkaido University Graduate School of Medicine |
| [ Summary ] | The Japanese Society for Helicobacter Research established the second version of guidelines for diagnosis and the treatment of Helicobacter pylori (H. pylori) infection in 2003. The first version guidelines, established in 2000, have gradually become unsuitable to the current clinical management of H. pylori. The most strongly recommended indications for H. pylori eradication, in the new guidelines include gastric ulcers, duodenal ulcers, and gastric MALT lymphoma. Gastric MALT lymphoma was newly added to there strongly recommended indications. Post endoscopic resection of gastric cancer, atrophic gastritis, and hyperplastic polyps were chosen as advisable indications under new categories in the new guidelines. Rapid urease tests, histological examination, cultures, urea breath test and blood antibody tests were indicated before and after eradication treatment in previous guidelines. The stool antigen test was admitted as an indicated diagnostic method for H. pylori infection. The basic regimen for firstline eradication treatment was a one week course of proton pump inhibitors (PPI), for based triple therapy. Omeprazole based triple therapy was additionally recommended in the new guidelines. A triple therapy including PPI, metronidazole and amoxicillin was recommended as back-up therapy after failure of first line therapy because clarithromycin resistant strains were the main reason for unsuccessful H. pylori eradication. | |