Abstract
Helicobacter pylori infection: Current management and treatment outcome monitoring strategies
Helicobacter pylori infection is one of the most common chronic bacterial infections worldwide which continues to represent an important public health problem. The Helicobacter pylori bacterium plays a key role in the pathogenesis of several gastrointestinal diseases, including chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue (MALT) lymphoma, and gastric cancer. Persistent colonization of the gastric mucosa induces chronic inflammation which in some patients may progress through a sequence of precancerous changes, known as the Correa cascade, and lead ultimately to gastric adenocarcinoma. Early detection and effective eradication of the infection are therefore essential for preventing disease progression and reducing the risk of serious complications. This paper summarizes the current diagnostic strategies, recommended eradication regimens, and approaches to monitoring treatment effectiveness. Diagnostic methods include both invasive testing, such as rapid urease test, histopathological examination, and bacterial culture, as well as non-invasive testing, such as urea breath test, stool antigen test, and serological tests. Among these, urea breath test and stool antigen test are considered to be the most reliable methods for detecting an active infection and confirming successful eradication of the infection. The growing prevalence of antibiotic resistance, particularly to clarithromycin and metronidazole, represents a major challenge in the management of H. pylori infection. Accordingly, current guidelines recommend using quadruple therapy as the preferred first-line treatment in many regions. Treatment success depends not only on the appropriate choice of therapeutic regimen but also on adequate suppression of gastric acid secretion and patient adherence to therapy. Post-treatment confirmation of eradication is recommended in all treated patients based on reliable non-invasive tests which should be performed at least four weeks at the end of full course of treatment.
Piśmiennictwo
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