The main risk factor for recurrence with H. pylori was found to be age, with the youngest children running the greatest risk. The finding lends support to the observation that early childhood may be the main age of acquisition of H. pylori infection and for postponing attempts

of eradication in high-prevalence areas unless motivated for medical reasons. “
“Several interesting studies have been published on nonmalignant Helicobacter pylori-related conditions over the past year, which are reviewed in this article. A revival selleck inhibitor of interest in the histologic classification of gastritis has led to grading of gastritis into stages correlating with risk of neoplastic progression, new data to improve this concept have been published. Unselected prescription of proton-pump inhibitors in patients with dyspepsia has been questioned by the finding FK866 cell line that withdrawal of proton-pump inhibitors induces acid-related symptoms in healthy volunteers, probably by the mechanism of rebound gastric acid hypersecretion. Additional

data on the rationale of tapering proton-pump inhibitor therapy are therefore awaited. Moreover, new data on peptic ulcer disease and its complications provide clear recommendations for daily clinical practice. Testing and eradication of H. pylori in patients with peptic ulcer bleeding is essential. However, in H. pylori-negative peptic ulcer disease, high overall patient mortality should be acknowledged, and this should guide considering continuation of nonsteroidal anti-inflammatory drugs. The role of H. pylori in the pathogenesis of gastroesophageal reflux disease is still unclear. An association has been described by several studies; however, it cannot be translated to individual risks for development of gastroesophageal MCE reflux disease after H. pylori eradication. Possibly, additional data on subgroups, such as gastric ulcer,

duodenal ulcer patients, and associated gastric mucosal changes, will solve this issue. Helicobacter pylori infection remains the most common chronic bacterial infection worldwide. The prevalence in developing countries is stably estimated between 60–90%, and the prevalence in the developed world is steadily declining over the past decades but is still at levels of 25–35% in many populations. Higher prevalences in Western countries in particular occur in those above the age of 50 years and in first- and second-generation immigrants. We recently observed a 65–96% prevalence of H. pylori infection in Dutch migrant communities with different geographic background [1]. Virtually, all these H. pylori-positive subjects develop chronic active gastritis. In addition, in a considerable proportion of these subjects, other H. pylori-associated conditions develop during the course of infection. The majority of these conditions are nonmalignant.