Helicobacter Pylori
Helicobacter pylori: Epidemiology, Pathogenesis and Diagnosis
"If these bacteria are truly associated with antral gastritis, as described by Warren, they may have a part to play in poorly understood, gastritis associated diseases (i.e. peptic ulcer and gastric cancer)."
Barry Marshall, 19831
Introduction:
Barry Marshall's and J. Robin Warren's (now "classic") letters to the Lancet in June 1983 suggesting that the, then unidentified, curved bacilli found in human gastric epithelia "may have a part to play in poorly understood, gastritis associated diseases (i.e. peptic ulcer and gastric cancer)" has deeply revolutionised the fields of Gastroenterology and Microbiology, causing an enormous impact on clinical management.1,2 The advent of Helicobacter pylori has brought about a complete revision of our concepts of chronic gastritis, peptic ulcer disease and even gastric cancer.3 Long before the culture of H pylori, spiral bacteria had been observed in the stomachs of a range of different animals. They were first reported in mammalian stomach just over 100 years ago.4,5 Since the isolation of H pylori by Warren and Marshal, gastric microbiology attracted world-wide attention and much information has accumulated on the basic bacteriology of H pylori.
Epidemiology The prevalence of H pylori in otherwise healthy individuals varies, depending mainly on age, education and income levels and country of origin. There are accumulating data suggesting that the major period of acquisition of infection is in childhood.6,7 The age of most frequent infection appears to be in person under 15 years of age, and perhaps in even younger children. The infection in children is mostly asymptomatic and not associated with specific clinical symptoms.8 Cohort studies in adults show acquisitions of about 0.3 to 0.5 per 100 person-years, in recent decades.6,7 H pylori infection is seen world-wide, while the frequency of associated illness is reported to vary. In India and Saudi
"If these bacteria are truly associated with antral gastritis, as described by Warren, they may have a part to play in poorly understood, gastritis associated diseases (i.e. peptic ulcer and gastric cancer)."
Barry Marshall, 19831
Introduction:
Barry Marshall's and J. Robin Warren's (now "classic") letters to the Lancet in June 1983 suggesting that the, then unidentified, curved bacilli found in human gastric epithelia "may have a part to play in poorly understood, gastritis associated diseases (i.e. peptic ulcer and gastric cancer)" has deeply revolutionised the fields of Gastroenterology and Microbiology, causing an enormous impact on clinical management.1,2 The advent of Helicobacter pylori has brought about a complete revision of our concepts of chronic gastritis, peptic ulcer disease and even gastric cancer.3 Long before the culture of H pylori, spiral bacteria had been observed in the stomachs of a range of different animals. They were first reported in mammalian stomach just over 100 years ago.4,5 Since the isolation of H pylori by Warren and Marshal, gastric microbiology attracted world-wide attention and much information has accumulated on the basic bacteriology of H pylori.
Epidemiology The prevalence of H pylori in otherwise healthy individuals varies, depending mainly on age, education and income levels and country of origin. There are accumulating data suggesting that the major period of acquisition of infection is in childhood.6,7 The age of most frequent infection appears to be in person under 15 years of age, and perhaps in even younger children. The infection in children is mostly asymptomatic and not associated with specific clinical symptoms.8 Cohort studies in adults show acquisitions of about 0.3 to 0.5 per 100 person-years, in recent decades.6,7 H pylori infection is seen world-wide, while the frequency of associated illness is reported to vary. In India and Saudi