A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication

Abstract

Helicobacter pylori (H. pylori) affects nearly half of the world’s population and, thus, is one of the most frequent and persistent bacterial infections worldwide. H. pylori is associated with peptic ulcer disease, gastric ulcers, mucosa-associated lymphoid tissue lymphoma, and gastric cancer. Various diagnostic methods exist to detect infection, and the choice of one method or another depends on several factors, such as accessibility, advantages and disadvantages of each method, cost, and the age of patients. Once H. pylori infection is diagnosed, the clinician decides whether treatment is necessity, according to the patient’s clinical condition. Typically, eradication of H. pylori is recommended for treatment and prevention of the infection. Cure rates with the standard triple therapy are acceptable, and effective quadruple therapies, sequential therapies, and concomitant therapies have been introduced as key alternatives to treat H. pylori infection. In this work, we review the main diagnostic methods used to identify H. pylori infection and to confirm eradication of infection. In addition, key factors related to treatment are reviewed.

Keywords: Diagnosis; Helicobacter pylori; Treatment; Hybrid therapy; Concomitant therapy; Sequential therapy

Core tip: This review focuses on diagnostic methods used to detect Helicobacter pylori (H. pylori) infection before and after eradication and on treatment regimens for H. pylori eradication. In this review, we emphasize the different regimens recommended in relation to differences in antibiotic resistance. Additionally, we review a test-and-treat strategy for and effective quadruple therapies, such as sequential, concomitant, and hybrid therapies. Furthermore, we review the use of probiotics as an additive to help increase H. pylori eradication rates.