Management of Helicobacter Pylori Infection

Since the initial isolation of Helicobacter pylori (H. pylori) in 1982 by Warren and Marshall, the diagnosis and treatment of H. pylori has remained problematic [1]. Although the incidence varies by geographic location and socioeconomic conditions, H. pylori remains one of the most common bacterial infections in the world [2]. The estimated incidence of H. pylori within the United States is 30-40% [3]. The association between H. pylori and gastric ulcers, duodenal ulcers, gastric adenocarcinoma, gastric MALT lymphomas and specific anemias has been clearly established [4-8]. Testing for H. pylori in these conditions as well as patients experiencing dyspeptic symptoms is generally recommended [9]. A number of testing options are available including biopsy based (histology, rapid urease testing, culture, rapid polymerase testing), serology, 13C urea breath testing and stool antigen, however each test possess their individual advantage and disadvantage [10-12]. Once the diagnosis is established, multiple treatment regimens are available yet the optimal treatment regimen has not been established. We aim to review the treatment options in the management of H. pylori infection.