The annual incidence of peptic ulcer disease in developed countries is around one to three per thousand inhabitants. Since the introduction of acid-secretion inhibitors, the indirect costs of this disease, which has a high rate of relapse, have steadily decreased, although direct costs have been increasing. The possibility of healing the patient through Helicobacter pylori eradication has the potential for a huge economic impact considering the long-term cost: benefit ratio. A recent study has shown that H. pylori eradication therapy can save between US$750,000 and US$1,000,000 per year per million inhabitants in western Europe compared to maintenance or episodic therapy. This paper reviews the cost implications of various management strategies for peptic ulcer disease, comparing the cost: benefit ratios of five different treatment regimens.
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Therap Adv Gastroenterol
January 2025
Digestive Disease Unit, Department of Medical-Surgical Sciences and Translational Medicine, Sant'Andrea Teaching Hospital, Sapienza University of Rome, via di Grottarossa 1035, Rome 00189, Italy.
Background: Efficacy of eradication regimens in (Hp) infection is commonly reported with proton pump inhibitors (PPIs). In patients with corpus atrophic gastritis, characterized by impaired acid secretion, PPI treatment is questionable.
Objectives: The current study aimed to assess in clinical practice the tolerability and eradication rate of modified eradication regimens without PPI as first-line treatment in patients with histologically Hp-positive corpus atrophic gastritis.
J Gastroenterol
January 2025
Faculty of Information Science and Technology, Hokkaido University, Sapporo, Japan.
Background: The automated classification of Helicobacter pylori infection status is gaining attention, distinguishing among uninfected (no history of H. pylori infection), current infection, and post-eradication. However, this classification has relatively low performance, primarily due to the intricate nature of the task.
View Article and Find Full Text PDFFunctional dyspepsia (FD) is a gut-brain axis disorder characterized by postprandial fullness, early satiety, bloating and/or epigastric pain, which are presumed to originate in the gastroduodenal tract. While the international recommendations in the Rome IV consensus require endoscopy to rule out an organic condition before establishing a diagnosis of FD, international guidelines recommend that, in the absence of risk factors, patient management be initiated at the primary care level by establishing Helicobacter pylori infection status, with eradication when positive, followed by empiric therapy with proton pump inhibitors and/or prokinetics, and that endoscopy be reserved for patients refractory to said measures. Second-line therapy includes neuromodulating agents, among which tricyclic antidepressants and atypical antipsychotics such as levosulpiride stand out.
View Article and Find Full Text PDFBMJ Open
December 2024
Department of Medicine, Shanghai Clinical Research Center, Shanghai, China
Introduction: is a major health problem, with the high prevalence of and the increasing antibiotic resistance rate in China. Antibiotic resistance is the main reason for the failure of eradication. This study aims to evaluate the efficacy and safety of susceptibility-guided quadruple therapy with antibiotic resistance using the string test coupled with quantitative PCR (qPCR) for eradication.
View Article and Find Full Text PDFClin J Gastroenterol
January 2025
Department of General Internal Medicine 2, Kawasaki Medical School General Medical Center, Okayama, Japan.
The relationship between autoimmune gastritis (AIG) and Helicobacter pylori (H. pylori) gastritis remains unclear, particularly whether there is any interaction. Herein, we report a case of early-stage AIG diagnosed in an elderly patient with highly active H.
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