Indications for H. pylori testing and treatment (short list)
Groups to test and treat for H. pylori infection:
• Peptic ulcer disease: prior history or active disease
• Margina zone B-cell lymphoma, MALT type
• Uninvesigated dyspepsia in patients who are under the age of 60 years
– In high-risk populations for gastric cancer, test and treat at age 45-50 years
• Functional dyspepsia
• Adult household members of individuals who have a positive non-serological test for H. pylori
• Patients taking long-term NSAIDs or starting long-term treatment with low-dose aspırın
• Patients with unexplained iron deficiency anemia
• Patients with idiopathic (autoimmune) thrombocytopenic purpura
• Primary and secondary prevention of gastric adenocarcinoma
-Current or history of gastric premalignant conditions (GPMC)
– Current or history of early gastric cancer resection
– Current or prior history of gastric adenocarcinoma
– Patients with gastric adenomas or hyperplastic polyps
Persons with a first degree relative with gastric cancerd
– Individuals at increased risk for gastric cancer including certain non-White racial/ethnic groups, immigrants from high gastric cancer incidence regions/countries, hereditary cancer syndromes associated with an increased risk for gastric cancer
– Patients with autoimmune gastritis
“In the absence of contraindications, H. pylori treatment should be offered to all patents with actve H. pylori infection, as indicated by a positive non-serological test.
Serological testing is not recommended in low-prevalence populat ons in the abserce of a high pre-test probability (e.g., peptic ulcer).
“GPVMC includes atrophic gastritis, intest nal metaplasia, and dysplasia.
Patents with adenomas and hyperpastc polyps often have associated GPMC.
Note:
- A decision to test and treat should follow shared cecision-making between the patient and provider.
- Don’t decide yourself for H pylori test rather discuss with your doctor or healthcare provider for possible indication.
