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Article
July 6, 1994

Helicobacter pylori in Peptic Ulcer Disease

Author Affiliations

Professor and Chair, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor; Denver (Colo) Medical Center; Professor of Medicine, Chief, Gastrointestinal Division, Department of Medicine, Washington University School of Medicine, St Louis, Mo; Professor of Medicine, Microbiology, and Immunology, Division of Gastroenterology, Department of Medicine, Stanford (Calif) University School of Medicine; Ann Arbor, Mich; Ann Arbor, Mich; Chief, Division of General Surgery, Department of Surgery, Milton S. Hershey Medical Center, Hershey, Pa; Chief, Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Boston; Department of Preventive Medicine, Vanderbilt University School of Medicine, Nashville, Tenn; Professor and Chairman, Department of Medicine, University of Tennessee College of Medicine, Memphis; Professor of Medicine, Division of Gastroenterology, University of Washington School of Medicine, Seattle; Professor of Medicine, Case Western Reserve University, Chief, Division of Gastroenterology, University Hospitals of Cleveland, Cleveland, Ohio; Assistant Clinical Professor, Division of Gastroenterology, George Washington University Medical Center, Washington, DC; Professor of Pediatrics, Director of Pediatrics and Infectious Diseases, The Johns Hopkins University School of Medicine, Baltimore, Md; "Helicobacter pylori: A Human Pathogen"; "Beneficial Effects of Eradication of Helicobacter pylori in Relationship to Ulcer Complications"; "Biological Plausibility of the Relationship Between Helicobacter pylori and Malignancy"; "Complications of Treatment for Eradication of Helicobacter pylori; "Evidence for Helicobacter pylori's Role as a Risk Factor for Malignancy"; "Antimicrobial Regimen Results of Clinical Trials" Richard H. Hunt, FRCP, FRCP(Edin), FRCPC, "Does Treatment With Antimicrobials Alter the Natural History of Peptic Ulcer Disease?"; "Limitations of the Helicobacter pylori Hypothesis"; "Current Uncertainties About the Impact of Helicobacter pylori on the Complications of Peptic Ulcer Disease"; "Helicobacter pylori: A Historical Perspective" and "Why, How, and When To Use Antimicrobials as Part of the Standard Management of Ulcer Disease in Order To Prevent Recurrences"; "Gastric Lymphoma: A Complication of Helicobacter pylori Infection"; "Evaluation of Helicobacter pylori in Relation to Other Causes of Peptic Ulcer Disease"; "Limitations of Helicobacter pylori Hypothesis in Gastric Cancer"; "Helicobacterpylori Diagnostic Tests: Benefits, Sensitivity, and Specificity"; "The Role of Acid Secretion in Peptic Ulcer Pathogenesis"; "Economics of Ulcer Treatment: The Impact of Ulcer Treatment With Antibiotics"; "Epidemiology of Helicobacter pylori Infections"; "Characterization of Dyspepsia"; "Which Treatment Regimens Have Been Shown To Be Effective in the Eradication of Helicobacter pylori and Thus Prevented Ulcer Recurrence?"; "The Role of Helicobacter pylori in Pathogenesis of Peptic Ulcer Disease"; "Susceptibility and Resistance of Antimicrobials in the Treatment of Helicobacter pylori"; "Helicobacter pylori and the Cause of Ulcer Disease"; Director, Digestive Diseases Programs, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Professor of Medicine, Director, Division of Infectious Diseases, Professor of Microbiology and Immunology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn; Associate Director for Disease Prevention and Technology Transfer, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Writer, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Program Analyst, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Director, Epidemiology and Data Systems Program, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Director, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Senior Staff Physician, Office of Disease Prevention and Technology Transfer, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Professor of Medicine and Molecular Virology, Baylor College of Medicine, Houston, Tex; Director of Communications, Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md; Director, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Md; Chief, Enteric Diseases Branch, Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Md; Research Foundation for Helicobacter and Intestinal Immunology, Charlottesville, Va; Assistant Professor, Division of Gastroenterology, Department of Medicine, Howard University Hospital, Washington, DC; Professor of Medicine, Gastroenteric Biology Center, Department of Medicine, UCLA School of Medicine Center for the Health Sciences, Center for Ulcer Research and Education (CURE), Los Angeles, Calif; Conference and Panel Chairperson, John G. Searle Professor and Chair, Department of Internal Medicine, University of Michigan Medical Center, Ann Arbor
From the Office of Medical Applications of Research, National Institutes of Health, Bethesda, Md.

JAMA. 1994;272(1):65-69. doi:10.1001/jama.1994.03520010077036
Abstract

The National Institutes of Health Consensus Development Conference on Helicobacter pylori in Peptic Ulcer Disease brought together specialists in gastroenterology, surgery, infectious diseases, epidemiology, and pathology, as well as the public to address the following questions: (1) What is the causal relationship of H pylori to upper gastrointestinal disease? (2) How does one diagnose and eradicate H pylori infection? (3) Does eradication of H pylori infection benefit the patient with peptic ulcer disease? (4) What is the relationship between H pylori infection and gastric malignancy? (5) Which H pylori—infected patients should be treated? (6) What are the most important questions that must be addressed by future research in H pylori infections? Following 1½ days of presentations by experts and discussion by the audience, a consensus panel weighed the evidence and prepared their consensus statement. Among their findings, the consensus panel concluded that (1) ulcer patients with H pylori infection require treatment with antimicrobial agents in addition to antisecretory drugs whether on first presentation with the illness or on recurrence; (2) the value of treating of nonulcerative dyspepsia patients with H pylori infection remains to be determined; and (3) the interesting relationship between H pylori infection and gastric cancers requires further exploration.

(JAMA. 1994;272:65-69)

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