Helicobacter pylori and ulcer disease
Rácz, I.
Orvosi Hetilap 137(27): 1459-1467
1996
ISSN/ISBN: 0030-6002 PMID: 9173367 Document Number: 458605
Helicobacter pylori (H. pylori) is the most common human gastrointestinal pathogen, infecting almost 50% of human population. By our present knowledge H. pylori is the cause of chronic active B type gastritis and the bacterium is accepted as a major pathogenetic factor of peptic ulcer disease. The prevalence of H. pylori positivity is about 95% in duodenal ulcer patients, in gastric ulcer patients 70-90% H. pylori positivity can be detected. The gastric mucosal barrier is weakened by the bacterial urease enzyme and vacoulating cytotoxin production. Special inflammatory and immunological processes as well H. pylori induced acid production increasing effects are also contributing to the pathogenesis of peptic ulcer disease. In the diagnosis of H. pylori the biopsy based invasive methods like histology and rapid urease test are offering the highest sensitivity and specificity. For controlling the eradication effect the most appropriate method is the isotope labelled urea breath test. In the lack of optimal H. pylori eradicating drug several combined therapeutical methods are available at present. Among the wide range of H. pylori eradicating regimens the macrolide or beta lactam antibiotics with nitromidazole and effective antisecretory drugs offer the highest eradication effect. In practice the low dose, short term administration of those compounds are most widely used presently.