From the Guidelines
Gastritis and H. pylori infection are distinct medical concepts, with H. pylori being a bacterial infection that commonly causes gastritis, and the primary difference between them lies in their etiology and treatment approaches. Gastritis is inflammation of the stomach lining that can cause symptoms like abdominal pain, nausea, and indigestion, while Helicobacter pylori (H. pylori) is a bacterial infection that is etiologically related to peptic ulcer and gastric cancer, as noted in a 2022 study published in the Annual Review of Medicine 1. The infection is generally acquired in childhood, especially via transmission within families, and the lifetime risk of peptic ulcer is approximately 1 in 6 (∼17%) among those with H. pylori infection.
Key Differences and Treatment Approaches
- Gastritis can be caused by various factors, including H. pylori infection, NSAIDs, alcohol, autoimmune conditions, and stress, whereas H. pylori infection is a specific bacterial infection that requires targeted treatment.
- H. pylori infection is diagnosed through breath tests, blood tests, stool tests, or endoscopy with biopsy, and the standard first-line treatment is triple therapy consisting of a proton pump inhibitor plus two antibiotics for 14 days, as recommended in the 2022 study 1.
- Eradication of H. pylori infection significantly reduces the risk of peptic ulcers and gastric cancer in infected individuals, with the lifetime risk of developing gastric cancer varying from approximately 0.6% to 22% worldwide, as reported in the study 1.
Importance of Eradication
The eradication of H. pylori infection is crucial in preventing the development of peptic ulcers and gastric cancer, and countries with a high prevalence of gastric cancer, such as Japan, Korea, Taiwan, and China, have introduced or are planning to introduce population-wide H. pylori eradication programs, as mentioned in the study 1. The current consensus is that H. pylori gastritis is associated with significant risk to the host and provides no proven benefits, and therefore, eradication of the infection is essential.
From the Research
Difference between Gastritis and H. pylori Infection
- Gastritis refers to the inflammation of the stomach lining, which can be caused by various factors, including H. pylori infection 2.
- H. pylori infection is a bacterial infection that can cause gastritis, as well as other conditions such as peptic ulcers and gastric cancer 3, 4, 5, 6.
Relationship between H. pylori Infection and Gastritis
- Studies have shown that eradication of H. pylori infection can lead to the resolution of gastritis 2, 5.
- However, severe gastritis may cause irreparable damage to the gastric mucosa, even after eradication of H. pylori infection 2.
Treatment of H. pylori Infection and Gastritis
- Various treatment regimens are available for H. pylori infection, including triple therapy with a proton-pump inhibitor, amoxicillin, and clarithromycin or metronidazole 3, 4, 5, 6.
- The choice of treatment regimen may depend on factors such as antibiotic resistance, patient allergies, and comorbidities 6.
Key Findings
- Eradication of H. pylori infection is essential for the resolution of gastritis 2, 5.
- The density of H. pylori colonization does not appear to be related to the severity of gastritis or the successful eradication of the infection 2.
- Different treatment regimens may have varying degrees of efficacy in eradicating H. pylori infection, and the choice of regimen should be individualized based on patient factors 3, 4, 5, 6.