Key topics in Helicobacter pylori eradication in the management of the dyspeptic patient: a panel discussion.

A panel of international gastroenterologists and other specialists convened at a Takeda-sponsored symposium held during the XIIIth International Workshop on Gastroduodenal Pathology and Helicobacter pylori (October 2000, Rome) to discuss clinical management of H. pylori. Topics such as management strategies as alternatives to eradication, long-term outcomes, and the impact of antibiotic resistance to H. pylori were discussed in an interactive session. The panel concluded that 1) patients with ulcer-like or reflux-like dyspepsia do appear to benefit from proton pump inhibitor therapy, 2) eradication of H. pylori may reduce future morbidity and mortality from peptic ulcer disease and gastric carcinoma, outweighing the theoretical risk of developing gastro-oesophageal reflux disease, Barrett's oesophagus, and oesophageal adenocarcinoma, and 3) the epidemiology of resistance to H. pylori, and the impact of the percentage of eradication, should be considered when an eradication regimen is being planned for patients with non-ulcer dyspepsia. Susceptibility testing may be of help in areas where this investigation is cost effective.