The Helicobacter pylori revolution: radiologic perspective

Helicobacter pylori is now recognized as an important factor in the development of gastritis, gastric and duodenal ulcers, gastric carcinoma, and even gastric lymphoma. It is currently recommended that patients with H pylori who have peptic ulcers receive triple antibiotic therapy, as well as conventional antiulcer agents, to accelerate healing of ulcers and decrease their rate of recurrence. H pylori gastritis may be manifested on barium studies by thickened gastric folds or, in severe disease, by markedly thickened, lobulated folds (ie, polypoid gastritis). Although endoscopy has been the standard for detecting H pylori, noninvasive breath tests and serologic tests for this infection are about to become widely available. Thus, in the future, patients suspected of having peptic ulcer disease could be evaluated with a noninvasive serum test for H pylori combined with a double-contrast upper gastrointestinal examination.