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Helicobacter pylori infection
What's new
Updated 2024 ACG guidelines for the management of Helicobacter pylori infection .
Background
Overview
Definition
H. pylori is a Gram-negative bacterium that causes chronic infection and inflammation of the stomach and duodenum.
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Pathophysiology
H. pylori infection is transmitted via the fecal-oral and oral-oral routes; horizontal transmission, and environmental transmission through contaminated water also occurs.
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Epidemiology
The prevalence of H. pylori infection in North America is decreasing over time but remains substantial at 30-40%. The infection is typically acquired in childhood and is more prevalent among non-White races and ethnicities, those living in crowded or poor sanitary conditions, and early-generation immigrants from countries where H. pylori is endemic. H. pylori resistance rates to antibiotics are increasing in most parts of the world.
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Disease course
H. pylori infection is associated with an increased risk of various gastrointestinal diseases including functional dyspepsia, gastritis, peptic ulcer disease, gastric intestinal metaplasia, and gastric cancer.
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Prognosis and risk of recurrence
Although successful eradication of H. pylori infection prevents the development and progression of H. pylori-associated diseases, the efficacy of treatment regimens has decreased due to increased antibiotic resistance. Globally, the annual recurrence, reinfection, and recrudescence rate of H. pylori is 4.3%, 3.1%, and 2.2%, respectively.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of Helicobacter pylori infection are prepared by our editorial team based on guidelines from the American College of Gastroenterology (ACG 2024,2017,2013,2007), the American Gastroenterological Association (AGA 2024,2021,2020), the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN/NASPGHAN 2024), the American Academy of Family Physicians (AAFP 2023), the European Society for Paediatric ...
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