Guidelines for the indications to test for and to treat Helicobacter pylori infection: Difference between revisions

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==2017 ACG guidelines for the indications to test for and to treat Helicobacter pylori infection==
==2017 ACG guidelines for the indications to test for and to treat Helicobacter pylori infection==
{|class="wikitable"  
{| class="wikitable"  
|-
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| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
| colspan="1" style="text-align:center; background:LightGreen" |[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Patients at increased risk of [[Peripheral arterial disease|PAD]] ( (Table 1) should undergo a comprehensive medical history and a review of symptoms to assess for exertional leg symptoms, including [[claudication]] or other walking impairment, ischemic rest pain, and non healing wounds.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: BNR]])''<nowiki>"</nowiki>
| bgcolor="LightGreen" |1.Since all patients with a positive test of active infection with H. pylori should be offered treatment, the critical issue is which patients should be tested for the
infection .
 
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Patients at increased risk of [[Peripheral arterial disease|PAD]] (Table 1) should undergo vascular examination, including palpation of lower extremity pulses (i.e., femoral, popliteal, dorsalis pedis, and posterior tibial), auscultation for femoral bruits, and inspection of the legs and feet.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: BNR]])''<nowiki>"</nowiki>
| bgcolor="LightGreen" |2.All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade
gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H.
 
pylori infection. Those who test positive should be offered treatment for the infection.
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Patients with [[Peripheral arterial disease|PAD]] should undergo noninvasive blood pressure measurement in both arms at least once during the initial assessment.''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: BNR]])''<nowiki>"</nowiki>
| bgcolor="LightGreen" |'''3.''' When upper endoscopy is undertaken in patients with dyspepsia, gastric biopsies should be taken to evaluate for H. pylori infection. Infected patients
should be offered eradication therapy .
|-
|Patients with typical symptoms of gastroesophageal refl ux disease (GERD) who do not have a history of PUD need not be tested for H. pylori infection.
However, for those who are tested and found to be infected, treatment should be offered, acknowledging that effects on GERD symptoms are unpredictable
|-
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|}

Revision as of 23:56, 30 November 2017


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2], Sargun Singh Walia M.B.B.S.[3]


2017 ACG guidelines for the indications to test for and to treat Helicobacter pylori infection

Class I
1.Since all patients with a positive test of active infection with H. pylori should be offered treatment, the critical issue is which patients should be tested for the

infection .

2.All patients with active peptic ulcer disease (PUD), a past history of PUD (unless previous cure of H. pylori infection has been documented), low-grade

gastric mucosa-associated lymphoid tissue (MALT) lymphoma, or a history of endoscopic resection of early gastric cancer (EGC) should be tested for H.

pylori infection. Those who test positive should be offered treatment for the infection.

3. When upper endoscopy is undertaken in patients with dyspepsia, gastric biopsies should be taken to evaluate for H. pylori infection. Infected patients

should be offered eradication therapy .

Patients with typical symptoms of gastroesophageal refl ux disease (GERD) who do not have a history of PUD need not be tested for H. pylori infection.

However, for those who are tested and found to be infected, treatment should be offered, acknowledging that effects on GERD symptoms are unpredictable

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