Helicobacter pylori and Less Common Gastric Diseases

Helicobacter pylori ( H. pylori) is associated with a wide spectrum of gastroduodenal diseases. Strong evidence has shown that H. pylori is implicated in the development of gastritis, gastric and duodenal ulcers, MALT lymphoma and gastric cancer. The result of multiple clinical trials had also found out that eradication of H. pylori results in cure of gastric and duodenal ulcers. The improvement of gastric inflammation after therapy is well documented and a substantial proportion of MALT lymphoma can be well treated by H. pylori eradication regimen. Progress has been made to widen the spectrum of gastric diseases associated with H. pylori infection. In recent years there were reports relating this microorganism with the less common gastric diseases. The long term complication of peptic ulcer disease, gastric outlet obstruction was found to be related to H. pylori infection in a substantial number of cases and eradication treatment can dilate the stenosis. As high as 90 % of Menetrier's disease had been found to be related to H. pylori infection. Possible elimination of gastric hyperplastic polyps by H. pylori eradication therapy had been reported. The possible role of H. pylori in lymphocytic gastritis and granulomatous gastritis had been well investigated. Revolutionalized concept to treat these diseases by antimicrobial therapy had been substantiated by the successful experience of various authors. However, large series of prospective randomized clinical trials are still lacking in these fields. ( J Intern Med Taiwan 2002;13:1-9