Helicobacter pylori: a primer for 1994.

Ten years after the original isolation of Helicobacter pylori, we know that this interesting new bacterium infects half of the world's population and at least 25% of people in the United States. The mode of transmission is probably fecal-oral, and its prevalence increases in lower socioeconomic groups or older people. Fortunately, the organism can now be diagnosed using serology, breath testing, biopsy, and culture. We also have effective means of therapy in the United States giving 80 to 95% cure rates in 14 days. In the past four years at least five well-controlled, double-blind studies have shown that curing Helicobacter pylori usually results in curing duodenal ulcer disease. Increasing data confirm that this also holds true for gastric-ulcer and ulcer complications. The role of Helicobacter pylori in non-ulcer dyspepsia is still controversial, and its association with increased gastric-cancer risk offers an exciting opportunity for further research.