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Friday 22 November 2024

Peer Reviewed

Gastroenterology clinic

How I manage asymptomatic patients with positive H. pylori serology

Anne Duggan

Recent articles on:
Peptic ulcer

Helicobacter pylori infection: when to search for it and how to diagnose it

Towards a diagnosis of functional dyspepsia

Helicobacter pylori: to treat or not to treat

Peptic ulcer disease: an update on diagnosis and treatment

How I manage asymptomatic patients with positive H. pylori serology

Recent articles on:
Digestive diseases

Dysphagia – an updated guide to investigation

Anal disorders – haemorrhoids, abscesses and fissures

Coeliac disease – optimising long-term management

Irritable bowel syndrome: an update on diagnosis and management

Is heartburn always reflux? An update on gastro-oesophageal reflux

Abstract

Helicobacter pylori infection is a cause of great confusion amongst the medical profession and the public. What do you do with a patient who tests positive for the bug but has no symptoms? Here, Anne Duggan shares her approach to the problem.

Key Points

Remember

‘Abnormal’ test results create patient anxiety. Consider whether you would treat a positive result in your patient before you order the test.
Treatment of H. pylori infection does have benefits. Known benefits include cure of peptic ulcer disease (in the absence of NSAIDs), and cure of the very rare MALT (mucosa associated lymphoid tissue) lymphoma. A reduced risk of gastric cancer is a possible benefit, but there are no data to support this. Most studies suggest there is no benefit from the eradication of H. pylori for symptoms of nonulcer dyspepsia.