Helicobacter pylori is a small, curved, microaerophilic, gram-negative, rod-shaped bacterium.
Believed to be fecal-oral or possibly oral-oral.
Common worldwide. Estimated prevalence is 70% in developing countries and 30%–40% in the United States and other industrialized countries.
Usually asymptomatic, but H. pylori is the major cause of peptic ulcer disease and gastritis, which presents as gnawing or burning epigastric pain. Less commonly, symptoms include nausea, vomiting, loss of appetite, or bleeding.
Fecal antigen assay, urea breath test, rapid urease test, or histology of biopsy specimen. A positive serology indicates present or past infection.
Treatment should be determined on an individual basis. Clarithromycin triple therapy (proton pump inhibitor [PPI] + clarithromycin + amoxicillin or metronidazole) or bismuth quadruple therapy (PPI or H2-blocker + bismuth + metronidazole + tetracycline). See www.acg.gi.org/physicians/guidelines/ManagementofHpylori.pdf.
No specific recommendations.
Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007 Aug;102(8):1808–25.
Lindkvist P, Wadstrom T, Giesecke J. Helicobacter pylori infection and foreign travel. J Infect Dis. 1995 Oct;172(4):1135–6.
Peterson WL, Fendrick AM, Cave DR, Peura DA, Garabedian-Ruffalo SM, Laine L. Helicobacter pylori-related disease: guidelines for testing and treatment. Arch Intern Med. 2000 May 8;160(9):1285–91.