Management of Helicobacter pylori related diseases:
Gespeichert in:
| Weitere Verfasser: | |
|---|---|
| Format: | Buch |
| Sprache: | English |
| Veröffentlicht: |
Philadelphia, Pa.
Elsevier
2015
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| Schriftenreihe: | Gastroenterology clinics of North America
44,3 |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XVI S., S. 507 - 698 Ill., graph. Darst. |
| ISBN: | 9780323395656 |
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Datensatz im Suchindex
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| adam_text | Titel: Management of Helicobacter pylori related diseases
Autor: Shiotani, Akiko
Jahr: 2015
Management of Helicobacter pylori-Related Diseases
Contents
Foreword: Helicobacter pylori xiii
Gary W. Falk
Preface: Helicobacter pylori: New Thoughts and Practices xv
Akiko Shiotani and David Y. Graham
Diagnosis of Helicobacter pylori Infection in the Proton Pump Inhibitor Era 507
Xavier Calvet
Proton pump inhibitors (PPI) are a major cause of false-negative Helico-
bacter pylori test results. Detecting PPI use and stopping it 2 weeks before
testing is the preferred approach to improve the reliability of H pylori diag-
nostic tests. Immunoblot and molecular methods may be useful for the
detection of H pylori infection in difficult cases. When conventional tests
are negative and eradication is strongly indicated, empirical H pylori treat-
ment should be considered. In this article, an updated critical review of the
usefulness of the various invasive and noninvasive tests in the context of
extensive PPI use is provided.
Practical Aspects in Choosing a Helicobacter pylori Therapy 519
Javier Molina-Infante and Akiko Shiotani
Cure rates greater than 90% to 95% should be expected with an antimicro-
bial therapy tor Helicobacter pylori infection. Standard triple therapy does
not guarantee these efficacy rates in most settings worldwide anymore.
The choice of eradication regimen should be dictated by factors that can
predict the outcome: (1 )H pylori susceptibility; (2) patients history of prior
antibiotic therapy; and (3) local data, either resistance patterns or clinical
success. Currently, the preferred first-line choices are 14-day bismuth
quadruple and 14-day non-bismuth quadruple concomitant therapy. Bis-
muth quadruple (if not used previously), fluoroquinolone-, furazolidone-
and rifabutin-containing regimens might be effective rescue treatments.
How to Effectively Use Bismuth Quadruple Therapy: The Good, the Bad, and the
Ugly 537
David Y. Graham and Sun-Young Lee
Bismuth triple therapy was the first effective Helicobacter pylori eradica-
tion therapy. The addition of a proton pump inhibitor helped overcome
metronidazole resistance. Its primary indication is penicillin allergy or
when clarithromycin and metronidazole resistance are both common.
Resistance to the primary first-line therapy have centered on complexity
and difficulties with compliance. Understanding regional differences in
effectiveness remains unexplained because of the lack of studies including
susceptibility testing and adherence data. We discuss regimen variations
including substitutions of doxycycline, amoxicillin, and twice a day therapy
viii Contents
and provide suggestions regarding what is needed to rationally and effec-
tively use bismuth quadruple therapy.
Is There a Role for Probiotics in Helicobacter pylori Therapy? 565
Maria P. Dore, Elisabetta Goni, and Francesco Di Mario
The role of probiotics in Helicobacter pylori therapy remains unclear. Lac-
tobacilli can be shown to inhibit H pylori in vitro. Some strains of Lactoba-
cilli may exert specific antimicrobial effects. There is no strong evidence of
a benefit on eradication rate when probiotics are added to a regimen.
Despite promising results obtained using compounds of L reuteri and S
boulardii, high-quality trials are needed to define the role of probiotics as
adjuvant therapy. Variables that remain to be studied with L reuteri,
currently the most promising strain, include dosage, frequency of admin-
istration, administration in relation to meals, and duration of therapy.
Molecular Approaches to Identify Helicobacter pylori Antimicrobial Resistance 577
Francis Megraud, Lucie Benejat, Esther Nina Ontsira Ngoyi, and
Philippe Lehours
Antimicrobial susceptibility testing is needed to adapt Helicobacter pylori
treatment to obtain the best results. Beside the standard phenotypic
methods, molecular methods are increasingly used. The value of these
molecular tests is that they are quick, independent of the transport condi-
tions, easy to standardize, and commercial kits are available. In this article,
these methods are reviewed, focusing on the determination of H pylori
resistance to macrolides and fluoroquinolones, and mentioning also the
methods used for tetracycline and rifampin.
When Is Endoscopic Follow-up Appropriate After Helicobacter pylori Eradication
Therapy? 597
Ernst J. Kuipers
The effect of Helicobacter pylori eradication treatment needs confirmation in
patients with persistent symptoms and in those with complicated peptic ul-
cer. Endoscopic surveillance after eradication is needed in patients with
advanced premalignant gastric lesions, previous early gastric cancer, gastric
MALT lymphoma, and in those with a hereditary gastric cancer risk.
Gastric Cancer Risk in Patients with Helicobacter pylori Infection and Following Its
Eradication 609
Massimo Rugge
As Helicobacter pylori is a first-class carcinogen, eradication of the infec-
tion would be expected to be a beneficial measure for the (primary) pre-
vention of gastric cancer. Given the natural history of gastric cancer, it is
plausible that eradication before gastric atrophy sets in offers the best
chance for cancer risk reduction. The beneficial effects of eradication
may, nevertheless, still be achievable in more advanced disease. The
reversibility of inflammatory lesions has been supported by undeniable ev-
idence; the regression of mucosal atrophy/metaplasia has also been
confirmed by several recent histologic studies.
Contents ix
Molecular Pathogenesis of Helicobacter pylori-Related Gastric Cancer 625
Takahiro Shimizu, Hiroyuki Marusawa, Norihiko Watanabe, and
Tsutomu Chiba
Helicobacter pylori infection plays a crucial role in gastric carcinogenesis.
H pylori exerts oncogenic effects on gastric mucosa through complex
interaction between bacterial virulence factors and host inflammatory re-
sponses. On the other hand, gastric cancer develops via stepwise accu-
mulation of genetic and epigenetic alterations in H pylori-infected gastric
mucosa. Recent comprehensive analyses of gastric cancer genomes indi-
cate a multistep process of genetic alterations as well as possible molec-
ular mechanisms of gastric carcinogenesis. Both genetic processes of
gastric cancer development and molecular oncogenic pathways related
to H pylori infection are important to completely understand the pathogen-
esis of H pylori-related gastric cancer.
Helicobacter pylori Eradication to Eliminate Gastric Cancer: The Japanese Strategy 639
Masahiro Asaka, Katsuhiro Mabe, Rumiko Matsushima, and Momoko Tsuda
Helicobacter pylori eradication therapy for chronic gastritis achieved
world-first coverage by the Japanese national health insurance scheme
in 2013, making a dramatic decrease of gastric cancer-related deaths
more realistic. Combining H pylori eradication therapy with endoscopic
surveillance can prevent the development of gastric cancer. Even if it de-
velops, most patients are likely to be diagnosed at an early stage, possibly
resulting in fewer gastric cancer deaths. Success with the elimination of
gastric cancer in Japan could lead other countries with a high incidence
to consider a similar strategy, suggesting the potential for elimination of
gastric cancer around the world.
Treatment Strategy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma 649
Shotaro Nakamura and Takayuki Matsumoto
Recent trends and current knowledge on the diagnosis and treatment
strategy for gastric mucosa-associated lymphoid tissue (MALT) lymphoma
are reviewed. Helicobacter pylori infection plays the causative role in the
pathogenesis, and Hpylori eradication is the first-line treatment of this dis-
ease, which leads to complete remission in 60% to 90% of cases. A Jap-
anese multicenter study confirmed that the long-term outcome of gastric
MALT lymphoma after H pylori eradication is excellent. Treatment strate-
gies for patients not responding to H pylori eradication including watch
and wait strategy, radiotherapy, chemotherapy, rituximab immuno-
therapy, and combination of these should be tailored in consideration of
the disease extent in each patient.
Rationale for a Helicobacter pylori Test and Treatment Strategy in
Gastroesophageal Reflux Disease 661
Nimish Vakil
Conflicting data have been published on the effect of long-term proton
pump inhibitor therapy on the gastric mucosa in Helicobacter pylori-in-
fected subjects. In this article, the available data are reviewed and a
x Contents
rationale is offered for why infected patients who are about to commence
long-term proton pump inhibitor therapy should be offered eradication
therapy.
Screening to Identify and Eradicate Helicobacter pylori Infection in Teenagers
in Japan 667
Taiji Akamatsu, Takuma Okamura, Yugo Iwaya, and Tomoaki Suga
The purpose of this study was to elucidate the prevalence and effect of
Helicobacter pylori infection in Japanese teenagers. The study subjects
were students ages 16 to 17 from one high school studied between
2007 and 2013. Students who tested positive on this screening examina-
tion underwent esophagogastroduodenoscopy and biopsy samples to
determine their H pylori status using culture and histology. Cure of H pylori
infections was determined by urea breath test. The low rate of prevalence
of H pylori infection in present Japanese teenagers makes it possible and
cost effective to perform examinations and carry out treatment of this
infection in nationwide health screenings of high school students.
Current Status and Prospects for a Helicobacter pylori Vaccine 677
Thomas G. Blanchard and Steven J. Czinn
Helicobacter pylori infection contributes to a variety of gastric diseases.
H pylori-associated gastric cancer is diagnosed in advanced stages,
and a vaccine against H pylori is desirable in parts of the world where
gastric cancer remains a common form of cancer. Some of the strategies
of vaccine development used in animals have been tested in several
phase 3 clinical trials; these trials have been largely unsuccessful,
although H pylori-specific immune responses have been induced. New
insights into promoting immunity and overcoming the immunosuppres-
sive nature of H pylori infection are required to improve the efficacy of
an H pylori vaccine.
Index
691
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| title_short | Management of Helicobacter pylori related diseases |
| title_sort | management of helicobacter pylori related diseases |
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