[Campylobacter pylori: significance, diagnosis and treatment]

The association between colonization of the antrum mucosa by Campylobacter pylori and antrum gastritis as well as peptic ulcers has been documented in a number of studies. The ability of these bacteria to produce a cytotoxin and a protease that hydrolyzes the mucosa-protecting mucin assigns pathogenetic properties to this species that suggest an etiological role for C. pylori in the pathogenesis of peptic ulcers and gastritis. This concept is supported by some preliminary results of therapeutic trials which have shown that successful eradication of the organism leads to histologic improvement of the gastritis and markedly reduced relapse rates regarding peptic lesions. Best results were achieved using combinations of a bismuth salt with an antibiotic such as amoxicillin. Diagnosis of C. pylori infection is based on culturing the organism from antral biopsies. Detecting the urease activity directly in the biopsy has also been shown to be an effective and reliable method. As a noninvasive method serologic testing for C. pylori may also be employed. An IgG-ELISA used by us showed a good correlation with cultural and histological results.