7 key H pylori points from the Maastricht V/Florence Consensus Report 2016

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7 key H pylori points from the Maastricht V/Florence Consensus Report 20161

  1. All patients who are H. pylori positive should be treated even if asymptomatic. 
  2. H. pylori eradication reduces but does not eliminate the risk of bleeding for those on NSAIDs, cox2 inhibitors or even low-dose aspirin after a peptic ulcer bleeding event, and that PPI co-therapy seems still necessary to reduce further the risk of upper GI bleeding. 
  3. Eradication of H. pylori heals gastritis in long-term PPI users irrespective of the continuation of acid suppressive drug.
  4. Urea Breath Test (In NZ the stool antigen test is the recommended one) is a valid and reliable test in the assessment of H. pylori eradication in the post-treatment evaluation.
  5. Eradication of H. pylori cures gastritis. 
  6. Metronidazole resistance and clarithromycin resistance issues require local guidance. 
  7. In areas of low clarithromycin resistance, triple therapy is recommended as first-line empirical treatment. Bismuth-containing quadruple therapy is an alternative.

 This GEM has been checked by Dr Alan Fraser, Gastroenterologist Mercy Specialist Centre

References:

  1. Malfertheiner, P et al. Management of Helicobacter pylori infection - the Maastricht V/Florence Consensus Report Click here

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.


As published in NZ Doctor 02/8/2017