Diagnosis and treatment in Helicobacter pylori infection

• Published in: Revue roumaine de médecine interne (1990) Vol. 48; no. 3; pp. 239 - 247
• Main Authors: Micu, Gianina, Stăniceanu, Florica, Zurac, Sabina, Popp, Cristiana, Bastian, Alexandra, Grămadă, Eliza, Mateescu, R, Rimbaş, M, Ivan, Delia Marga
• Format: Journal Article
• Language: English
• Published: Germany 2010
• Subjects: Anti-Bacterial Agents - therapeutic use; Antigens, Bacterial - analysis; Bacterial Vaccines; Drug Therapy, Combination; Feces - microbiology; Helicobacter Infections - diagnosis; Helicobacter Infections - drug therapy; Helicobacter Infections - prevention & control; Helicobacter Infections - therapy; Helicobacter pylori; Humans; Proton Pump Inhibitors - administration & dosage; Urease - metabolism
• ISSN: 1220-4749

In our days, Helicobacter pylori is considered to be the bacterium responsible for the most frequent and persistent chronic infection worldwide, involving half of the entire world population. Untreated, the infection is lasting for the whole life. In Romania, the number of carrying people is variable between 90-94%, while in western countries, the prevalence of this infection is much lower, under 50-60%, with a high tendency to decrease, due both to the higher socio-economic level and to advanced methods of diagnosis and treatment, with a special focus on prevention. Because a percentage of 10-11% of the infected people develop in time an ulcerous disease, and 5-6% will have premalignant changes on the gastric mucosa and even gastric cancer in 1% of the cases, the goal to detect and treat H. pylori infection is, in our opinion, very much justified by both theoretical and practical reasons. Diagnosis methods for the infection's detection are numerous and diverse, the choice for one or another depending on several factors, among which: accessibility, advantages and disadvantages specific to each method (particularly the method's invasive or non invasive character), the cost, the aim (diagnosis, epidemiological, the treatment's efficiency, etc.). From a clinical point of view the patient's age, antecedents and digestive symptoms, as well as his psychological state and associated treatments are also important. Once the diagnosis of infection is proved, the treatment of the Helicobacter pylori infection supposes the simultaneous administration of antibiotics and proton pump inhibitors. The idea to create a vaccine for Helicobacter pylori is the evident result of the need to avoid the costs imposed by the diagnosis and treatment of the infection, especially in view of the high percentage of failure in eradicating the infection. If we add to these the socio-economic costs brought by the treatment of gastric ulcers and cancers, the idea of using a vaccine with double role, both in preventing, as well as in treating the infection, is even more attractive.