Management of Helicobacter pylori Infection -- American Family Physician

www.aafp.org/afp AMERICAN FAMILY PHYSICIAN 1327 toms in 90 percent of infected persons. The prevalence of H. pylori infection varies geographically and has been demonstrated to be as high as 52 percent in the United States. Factors associated with higher infection rates are increasing age, African-American or Hispanic race, lower levels of education, and birth in a developing country. The pathogenic role of H. pylori in peptic ulcer disease, both duodenal and gastric, is well recognized—up to 95 percent of patients with duodenal ulcers and 80 percent of patients with gastric ulcers are infected. Eradication of the organism leads to ulcer healing and a markedly lower incidence of recurrence. The role of H. pylori in nonulcer dyspepsia has not been proved and, in most patients, eradication is not associated with improvement of symptoms. Most patients, however, present to the family physician with undifferentiated dyspepsia, not knowing whether an ulcer exists.