Helicobacter pylori: an update and a practical approach.

Infections with Helicobacter pylori are very common throughout the world, occurring in 40% to 50% of the population in developed countries and in 80% to 90% of the population in developing regions. Helicobacter pylori is now recognized as a major cause of gastritis and peptic ulcer disease; it has been implicated as a cause of gastric mucosa-associated lymphoid-tissue lymphomas, and it increases the risk of gastric adenocarcinoma in chronic carriers. Eradication of Helicobacter pylori has been shown to decrease ulcer recurrence and, in some cases, is associated with regression of the gastric mucosa-associated lymphoid-tissue lymphoma. Helicobacter pylori infection has been classified as a category 1 carcinogen by the World Health Organization. Treatment should be offered if the infection is detected. It is important for primary care physicians to clearly understand when and how to test and how to select appropriate therapy for Helicobacter pylori infection.