[Helicobacter and peptic ulcer: history, diagnosis and therapy--when, in whom and how?]

The pathogenesis of peptic ulcer disease is complex. It is associated with a spiral organism, Helicobacter pylori, which induces chronic gastritis. The evidence for a causal association between H. pylori and peptic ulcer disease stems primarily from the observation that eradication therapy with bismuth and various antibiotics may produce normalization of gastritis and possible cure of ulcer disease. The prevalence of H. pylori infection and potential implications for therapy are discussed. Who should undergo eradication therapy, and how? The problem remains that--despite the fact that a cure is possible--no simple therapy is available.