[Follow-up of patients after Helicobacter pylori eradication]

After Helicobacter pylori eradication, the risk of new contamination in adulthood is very low and there is no need for further microbiological surveillance. Helicobacter pylori infection induces alteration of the gastric mucosa, beginning with chronic active gastritis and leading to atrophy, intestinal metaplasia and dysplasia. Chronic active gastritis disappears completely a few months after bacterial eradication while atrophy, intestinal metaplasia or dysplasia remain. Mucosal atrophy and intestinal metaplasia confer a high risk for the development of gastric cancer. The risk of cancer occurring on these premalignant lesions depends on their extension, topography and severity. So their diagnosis and grading is important for cancer prevention and implies that antral and fundic biopsies are systematically done even on endoscopically normal mucosa. Low grade atrophy or intestinal metaplasia limited to the antrum do not require further surveillance. For high grade or fundic lesions reassessment of endoscopic and histologic lesions is recommended every three years. Dysplasia should undergo specialized management.