Eradication Therapy Should Be Different for Dyspeptic Patients than for Ulcer Patients
Physicians should try to achieve an optimal cure rate with their initial Helicobacter pylori eradication therapy. Most physicians use the same treatment in all their patients. H pylori infection in patients with peptic ulcer disease (PUD) is more likely to be cured than that in patients with functio...
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2003-01-01
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| Series: | Canadian Journal of Gastroenterology |
| Online Access: | http://dx.doi.org/10.1155/2003/136716 |
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| Summary: | Physicians should try to achieve an optimal cure rate with their initial
Helicobacter pylori eradication therapy. Most physicians use the
same treatment in all their patients. H pylori infection in patients
with peptic ulcer disease (PUD) is more likely to be cured than that
in patients with functional dyspepsia (FD). Differences in cure rates
of 5% to 15% are usually reported, which is considered to be clinically
relevant. A plausible biological explanation for this finding suggests
that different strains (virulent [cagA+, vacA type s1] compared
with nonvirulent strains [cagA–, vacA type s2]) in PUD and FD
induce different changes in the gastric mucosa, and this facilitates or
impairs antimicrobial efficacy. Physicians should be aware that most
published treatment studies have included only PUD patients. This
means that in clinical practice cure rates obtained in patients with
FD or perhaps uninvestigated dyspepsia are usually lower than those
reported in the literature. This has implications for the choice of
treatment. Physicians should consider prolonging the duration of initial
Helicobacter eradication therapy from seven to 10 to 14 days in
patients without ulcers. |
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| ISSN: | 0835-7900 |