Guidelines for the indications to test for and to treat Helicobacter pylori infection

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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

Strong recommendation
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.

4.Patients with typical symptoms of gastroesophageal reflux 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

Class IIa
"1.In patients with PAD and an abnormal resting ABI (≤0.90), exercise treadmill ABI testing can be useful to objectively assess functional status. (Level of Evidence: B-NR)"
"2. In patients with normal (1.00–1.40) or borderline (0.91–0.99) ABI in the setting of nonhealing wounds or gangrene, it is reasonable to diagnose CLI by using TBI with waveforms, transcutaneous oxygen pressure (TcPO2), or skin perfusion pressure (SPP). (Level of Evidence: B-NR)"
"3. In patients with PAD with an abnormal ABI (≤0.90) or with noncompressible arteries (ABI >1.40 and TBI ≤0.70) in the setting of nonhealing wounds or gangrene, TBI with waveforms, TcPO2, or SPP can be useful to evaluate local perfusion. (Level of Evidence: B-NR)"
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