An Updated Approach to Evaluation and Treatment of Helicobacter pylori Infection

Helicobacter pylori is a chronic bacterial infection that can lead to peptic ulcer disease, chronic gastritis, and gastric cancer. Its prevalence in the United States is lower than in most of the world, although specific populations are at particular risk for disease-related complications, including those with lower socioeconomic status and older adults. Since its discovery, there have been advances in H. pylori diagnosis and treatment, which are the focus of this review for general practice. Practice guidelines have expanded the role for treatment, despite traditional management algorithms resulting in diminished effectiveness as a result of increasing antibiotic resistance. In this context, new approaches warrant discussion. As such, this review aims to provide a clinical context and framework for the testing and rational treatment of H. pylori infection consistent with the available evidence.