Mistakes in the management of Helicobacter pylori infection and how to avoid them

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Mistakes in the management of Helicobacter pylori infection and how to avoid them

Neil O´Morain, Anthony O'Connor

Summary

AI Generated

Helicobacter pylori, a Group 1 carcinogen affecting billions globally, shows declining infection rates in Europe with Dutch data demonstrating seroprevalence dropping from 48% to 16% across birth cohorts.

Helicobacter pylori infection is classified as a Group 1 carcinogen and its sequelae can lead to significant morbidity and mortality worldwide
Billions of people are currently infected with H. pylori globally
The incidence of H. pylori infection is declining in many parts of Europe
A Netherlands study showed seroprevalence declined from 48% in subjects born 1935-1946 to 16% in those born 1977-1987

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10 Mistake 11

van Blankenstein M, van Vuuren AJ, Looman CW, et al. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol 2013; 48: 794–800. [Link]

(#ref2)Malfertheiner P, Megraud F, Rokkas T et al; European Helicobacter and Microbiota Study group. Management of Helicobacter pylori infection: the Maastricht VI/Florence consensus report. Gut. 2022 Aug 8:gutjnl-2022-327745. [Link]

Gisbert JP and Pajares JM. 13C-urea breath test in the diagnosis of Helicobacter pylori infection—a critical review. Aliment Pharmacol Ther 2004; 20: 1001–1017. [Link]

Yuan Y, Ford AC, Khan KJ, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database Syst Rev 2013; 12: CD008337. [Link]

Molina-Infante J, Lucendo AJ, Angueira T, et al. Optimised empiric triple and concomitant therapy for Helicobacter pylori eradication in clinical practice: the OPTRICON study. Aliment Pharmacol Ther 2015; 41: 581–589. [Link]

O’Connor HJ. Review article: Helicobacter pylori and gastro-oesophageal reflux disease—clinical implications and management. Aliment Pharmacol Ther 1999; 13: 117–127. [Link]

Moayyedi P. Feltbower R, Brown J, et al. Effect of population screening and treatment for Helicobacter pylori on dyspepsia and quality of life in the community: a randomised controlled trial. Lancet 2000; 355: 1665–1669. [Link]

Harvey RF, Lane JA, Murray LJ, et al. Randomised controlled trial of effects of Helicobacter pylori infection and its eradication on heartburn and gastro-oesophageal reflux: Bristol Helicobacter project. BMJ 2004; 328: 1417–1420. [Link]

Yaghoobi M, Farrokhyar F, Yuan Y, et al. Is there an increased risk of GERD after Helicobacter pylori eradication?: a meta-analysis. Am J Gastroenterol 2010; 105: 1007–1013. [Link]

10.

Fitzmaurice C, Allen C, Barber R, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study. JAMA Oncol 2017; 4: 524–548. [Link]

11.

Lee M, Kemp JA, Canning A, et al. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch Intern Med 159: 2312–2316. [Link]

12.

Graham D, Lew G, Malaty H, et al. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology 1992; 102: 493–496. [Link]

13.

Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975; 2: 58–60. [Link]

14.

O’Connor A, O’Moráin NR, Dobson M, et al. 182 Test, treat and retest. Who is best at checking for Helicobacter pylori eradication after a positive urea breath test (UBT), family physicians or gastroenterologists? Gastroenterology 2010; 138 (Suppl 1): S-33, DOI: 10.1016/S0016-5085(10)60153-9. [Link]

15.

Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42. [Link]

16.

Weston AP, Campbell DR, Hassanein RS, et al. Prospective, multivariate evaluation of CLOtest performance. Am J Gastroenterol 1997; 92: 1310–1315. [Link]

17.

Moon SW, Kim TH, Kim HS, et al. United rapid urease test is superior than separate test in detecting Helicobacter pylori at the gastric antrum and body specimens. Clin Endosc 2012; 45: 392–396. [Link]

18.

Zou Y, Qian X, Liu X et al . The effect of antibiotic resistance on Helicobacter pylori eradication efficacy: A systematic review and meta-analysis. Helicobacter. 2020;25(4):e12714.

Abstract

The sequelae of Helicobacter pylori infection, a known Group 1 carcinogen, can lead to significant morbidity and mortality worldwide. Billions of people are infected with H. pylori, but the incidence of H. pylori infection is declining in many parts of Europe, with a study from the Netherlands showing a decline in seroprevalence from 48% in subjects born between 1935 and 1946 to 16% in those born between 1977 and 1987

Topics

Stomach & H. Pylori

Citation

O’Connor A and O’Moráin C. Mistakes in the management of Helicobacter pylori infection and how to avoid them. UEG Education 2017; 17: 42–44.

Published

2024

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Mistakes in abdominal distension and how to avoid them

Elizabeth Barba Orozco, Alberto Ezquerra-Durán

Summary

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Summary is not available for this content yet.

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10 Mistake 11

van Blankenstein M, van Vuuren AJ, Looman CW, et al. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol 2013; 48: 794–800. [Link]

Gisbert JP and Pajares JM. 13C-urea breath test in the diagnosis of Helicobacter pylori infection—a critical review. Aliment Pharmacol Ther 2004; 20: 1001–1017. [Link]

Yuan Y, Ford AC, Khan KJ, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database Syst Rev 2013; 12: CD008337. [Link]

O’Connor HJ. Review article: Helicobacter pylori and gastro-oesophageal reflux disease—clinical implications and management. Aliment Pharmacol Ther 1999; 13: 117–127. [Link]

Yaghoobi M, Farrokhyar F, Yuan Y, et al. Is there an increased risk of GERD after Helicobacter pylori eradication?: a meta-analysis. Am J Gastroenterol 2010; 105: 1007–1013. [Link]

10.

11.

Lee M, Kemp JA, Canning A, et al. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch Intern Med 159: 2312–2316. [Link]

12.

Graham D, Lew G, Malaty H, et al. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology 1992; 102: 493–496. [Link]

13.

Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975; 2: 58–60. [Link]

14.

15.

Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42. [Link]

16.

Weston AP, Campbell DR, Hassanein RS, et al. Prospective, multivariate evaluation of CLOtest performance. Am J Gastroenterol 1997; 92: 1310–1315. [Link]

17.

18.

Zou Y, Qian X, Liu X et al . The effect of antibiotic resistance on Helicobacter pylori eradication efficacy: A systematic review and meta-analysis. Helicobacter. 2020;25(4):e12714.

Abstract

Abdominal distension and bloating are among the most frequently misunderstood complaints in gastroenterology. They are often used as interchangeable terms, a conceptual mistake that continues to drive diagnostic errors and ineffective treatment. According to Rome IV, bloating and distension may represent either a primary disorder of gut–brain interaction (DGBI) or occur as symptoms with other DGBIs, such as irritable bowel syndrome (IBS), functional dyspepsia (FD) or functional constipation (FC).

Topics

Neurogastroenterology & Motility

Citation

Barba-Orozco E and Ezquerra-Durán A. Mistakes in abdominal distension and bloating and how to avoid them. UEG Education 2026; 26: 5-9.

Published

2026

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UEG Podcast Episode

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MASLD with Sven Francque - Part 2

Sven Francque, Pradeep Mundre

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Summary is not available for this content yet.

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Abstract

Topics

Hepatobiliary

Published

2026

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Mistakes in rumination syndrome and how to avoid them

Alberto Ezquerra-Durán, Elizabeth Barba Orozco

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10 Mistake 11

van Blankenstein M, van Vuuren AJ, Looman CW, et al. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol 2013; 48: 794–800. [Link]

Gisbert JP and Pajares JM. 13C-urea breath test in the diagnosis of Helicobacter pylori infection—a critical review. Aliment Pharmacol Ther 2004; 20: 1001–1017. [Link]

Yuan Y, Ford AC, Khan KJ, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database Syst Rev 2013; 12: CD008337. [Link]

O’Connor HJ. Review article: Helicobacter pylori and gastro-oesophageal reflux disease—clinical implications and management. Aliment Pharmacol Ther 1999; 13: 117–127. [Link]

Yaghoobi M, Farrokhyar F, Yuan Y, et al. Is there an increased risk of GERD after Helicobacter pylori eradication?: a meta-analysis. Am J Gastroenterol 2010; 105: 1007–1013. [Link]

10.

11.

Lee M, Kemp JA, Canning A, et al. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch Intern Med 159: 2312–2316. [Link]

12.

Graham D, Lew G, Malaty H, et al. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology 1992; 102: 493–496. [Link]

13.

Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975; 2: 58–60. [Link]

14.

15.

Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42. [Link]

16.

Weston AP, Campbell DR, Hassanein RS, et al. Prospective, multivariate evaluation of CLOtest performance. Am J Gastroenterol 1997; 92: 1310–1315. [Link]

17.

18.

Zou Y, Qian X, Liu X et al . The effect of antibiotic resistance on Helicobacter pylori eradication efficacy: A systematic review and meta-analysis. Helicobacter. 2020;25(4):e12714.

Abstract

Topics

Neurogastroenterology & Motility

Citation

Ezquerra-Durán A and Barba-Orozco E. Mistakes in rumination syndrome and how to avoid them. UEG Education 2025; 25: 10-13.

Published

2025

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Mistakes in the use of PPIs and how to avoid them

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Mistakes in the use of PPIs and how to avoid them

Albert J. Bredenoord, Roos E. Pouw

Summary

AI Generated

Summary is not available for this content yet.

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References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10 Mistake 11

van Blankenstein M, van Vuuren AJ, Looman CW, et al. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol 2013; 48: 794–800. [Link]

Gisbert JP and Pajares JM. 13C-urea breath test in the diagnosis of Helicobacter pylori infection—a critical review. Aliment Pharmacol Ther 2004; 20: 1001–1017. [Link]

Yuan Y, Ford AC, Khan KJ, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database Syst Rev 2013; 12: CD008337. [Link]

O’Connor HJ. Review article: Helicobacter pylori and gastro-oesophageal reflux disease—clinical implications and management. Aliment Pharmacol Ther 1999; 13: 117–127. [Link]

Yaghoobi M, Farrokhyar F, Yuan Y, et al. Is there an increased risk of GERD after Helicobacter pylori eradication?: a meta-analysis. Am J Gastroenterol 2010; 105: 1007–1013. [Link]

10.

11.

Lee M, Kemp JA, Canning A, et al. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch Intern Med 159: 2312–2316. [Link]

12.

Graham D, Lew G, Malaty H, et al. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology 1992; 102: 493–496. [Link]

13.

Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975; 2: 58–60. [Link]

14.

15.

Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42. [Link]

16.

Weston AP, Campbell DR, Hassanein RS, et al. Prospective, multivariate evaluation of CLOtest performance. Am J Gastroenterol 1997; 92: 1310–1315. [Link]

17.

18.

Zou Y, Qian X, Liu X et al . The effect of antibiotic resistance on Helicobacter pylori eradication efficacy: A systematic review and meta-analysis. Helicobacter. 2020;25(4):e12714.

Abstract

Proton pump inhibitors (PPIs), first introduced with omeprazole in 1988, revolutionized the treatment of gastric acid-related conditions like gastro-oesophageal reflux disease, gastroduodenal ulcers, and Helicobacter pylori infections. Despite their effectiveness, PPIs are often prescribed for conditions without a proven link to gastric acid, such as dyspepsia and upper abdominal discomfort. Long-term use of PPIs has raised safety concerns, including risks of vitamin and mineral malabsorption, pneumonia, gastrointestinal infections, and dementia. This Mistakes In article addresses nine common mistakes in PPI use and aims to clarify misconceptions about their use.

Topics

Digestive Oncology Oesophagus

Citation

Pouw R.E. and Bredenoord A.J. Mistakes in the use of PPIs and how to avoid them. UEG Education 2017; 17: 15–17.

Published

2024

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This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

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Mistakes in gastroparesis and how to avoid them

Asma Fikree

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10 Mistake 11

van Blankenstein M, van Vuuren AJ, Looman CW, et al. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol 2013; 48: 794–800. [Link]

Gisbert JP and Pajares JM. 13C-urea breath test in the diagnosis of Helicobacter pylori infection—a critical review. Aliment Pharmacol Ther 2004; 20: 1001–1017. [Link]

Yuan Y, Ford AC, Khan KJ, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database Syst Rev 2013; 12: CD008337. [Link]

O’Connor HJ. Review article: Helicobacter pylori and gastro-oesophageal reflux disease—clinical implications and management. Aliment Pharmacol Ther 1999; 13: 117–127. [Link]

Yaghoobi M, Farrokhyar F, Yuan Y, et al. Is there an increased risk of GERD after Helicobacter pylori eradication?: a meta-analysis. Am J Gastroenterol 2010; 105: 1007–1013. [Link]

10.

11.

Lee M, Kemp JA, Canning A, et al. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch Intern Med 159: 2312–2316. [Link]

12.

Graham D, Lew G, Malaty H, et al. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology 1992; 102: 493–496. [Link]

13.

Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975; 2: 58–60. [Link]

14.

15.

Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42. [Link]

16.

Weston AP, Campbell DR, Hassanein RS, et al. Prospective, multivariate evaluation of CLOtest performance. Am J Gastroenterol 1997; 92: 1310–1315. [Link]

17.

18.

Zou Y, Qian X, Liu X et al . The effect of antibiotic resistance on Helicobacter pylori eradication efficacy: A systematic review and meta-analysis. Helicobacter. 2020;25(4):e12714.

Abstract

The term ‘gastroparesis’ was first coined by Kassander in 1958 to describe the fact that barium did not leave the stomach of patients with diabetes for over 24 hours — so-called ‘gastroparesis diabeticorum’. Nowadays it refers to a delay in gastric emptying that is associated with symptoms primarily of nausea and vomiting as well as the absence of mechanical obstruction. In 1958, 21 cases were described, but in 2019, 5 million US individuals were diagnosed as having gastroparesis. This rapid increase in prevalence is likely to have occurred because it has become much easier to measure gastric emptying and to attribute symptoms to this without necessarily thinking through differentials. The incidence of hospital admissions for patients labelled as having gastroparesis is rapidly rising, increasing at a much faster rate than admissions for patients with nausea and vomiting, gastro-oesophageal reflux disease, gastritis or gastric ulcers, which are all remaining relatively static. Gastroparesis therefore represents a major healthcare burden. Gastroparesis can be idiopathic or is most frequently caused by diabetes (type 1 more than type 2) or surgical procedures that can disrupt the vagus nerve (e.g. Billroth gastrectomy, oesophagectomy, gastric bypass surgery and fundoplication). In this article, I describe the mistakes most frequently made in patients who have a suspected diagnosis of gastroparesis. I base my discussion on the available evidence as well as clinical experience in the field.

Topics

Neurogastroenterology & Motility Stomach & H. Pylori

Citation

Fikree A. Mistakes in gastroparesis and how to avoid them. UEG Education 2021; 21: 18–22.

Published

2021

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Elizabeth Barba Orozco

Mistakes in the use of PPIs and how to avoid them

Albert J. Bredenoord

Mistakes in gastroparesis and how to avoid them

Asma Fikree

Mistakes in eosinophilic oesophagitis and how to avoid them

Alfredo J. Lucendo

UEG Mistakes In Articles

Share via Email Share on Facebook Share on X Share on LinkedIn Share on Bluesky

This content is part of Gutflix. Log in with your myUEG account, or create one free, to watch it.

Not sure what you can access? Learn more about account types.

Mistakes in eosinophilic oesophagitis and how to avoid them

Alfredo J. Lucendo, Javier Molina-Infante

Summary

AI Generated

Summary is not available for this content yet.

Download PDF

Was this helpful?

Thanks for your feedback.

References

Mistakes

References

Mistake 1 Mistake 2 Mistake 3 Mistake 4 Mistake 5 Mistake 6 Mistake 7 Mistake 8 Mistake 9 Mistake 10 Mistake 11

van Blankenstein M, van Vuuren AJ, Looman CW, et al. The prevalence of Helicobacter pylori infection in the Netherlands. Scand J Gastroenterol 2013; 48: 794–800. [Link]

Gisbert JP and Pajares JM. 13C-urea breath test in the diagnosis of Helicobacter pylori infection—a critical review. Aliment Pharmacol Ther 2004; 20: 1001–1017. [Link]

Yuan Y, Ford AC, Khan KJ, et al. Optimum duration of regimens for Helicobacter pylori eradication. Cochrane Database Syst Rev 2013; 12: CD008337. [Link]

O’Connor HJ. Review article: Helicobacter pylori and gastro-oesophageal reflux disease—clinical implications and management. Aliment Pharmacol Ther 1999; 13: 117–127. [Link]

Yaghoobi M, Farrokhyar F, Yuan Y, et al. Is there an increased risk of GERD after Helicobacter pylori eradication?: a meta-analysis. Am J Gastroenterol 2010; 105: 1007–1013. [Link]

10.

11.

Lee M, Kemp JA, Canning A, et al. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch Intern Med 159: 2312–2316. [Link]

12.

Graham D, Lew G, Malaty H, et al. Factors influencing the eradication of Helicobacter pylori with triple therapy. Gastroenterology 1992; 102: 493–496. [Link]

13.

Correa P, Haenszel W, Cuello C, et al. A model for gastric cancer epidemiology. Lancet 1975; 2: 58–60. [Link]

14.

15.

Megraud F, Coenen S, Versporten A, et al. Helicobacter pylori resistance to antibiotics in Europe and its relationship to antibiotic consumption. Gut 2013; 62: 34–42. [Link]

16.

Weston AP, Campbell DR, Hassanein RS, et al. Prospective, multivariate evaluation of CLOtest performance. Am J Gastroenterol 1997; 92: 1310–1315. [Link]

17.

18.

Zou Y, Qian X, Liu X et al . The effect of antibiotic resistance on Helicobacter pylori eradication efficacy: A systematic review and meta-analysis. Helicobacter. 2020;25(4):e12714.

Abstract

Eosinophilic oesophagitis (EoE) is a chronic immune-mediated inflammatory condition that is confined to the oesophagus. Clinically, EoE is characterized by symptoms of oesophageal dysfunction; histologically, by eosinophil-predominant inflammation.1,2 At present, EoE is the second-most frequent cause of chronic oesophagitis (gastro-oesophageal reflux disease [GORD] is the primary cause) and the foremost cause of dysphagia and food impaction in young adults and children.

Topics

Oesophagus

Citation

Molina-Infante J and Lucendo AJ. Mistakes in eosinophilic oesophagitis and how to avoid them. UEG Education 2017: 17; 6–9.

Published

2024

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Albert J. Bredenoord

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Asma Fikree

Mistakes in eosinophilic oesophagitis and how to avoid them

Alfredo J. Lucendo