Helicobacter pylori (H. pylori) is an extremely common, yet underappreciated, pathogen that is able to alter host physiology and subvert the host immune response, allowing it to persist for the life of the host. H. pylori is the primary cause of peptic ulcers and gastric cancer. In the United States, the annual cost associated with peptic ulcer disease is estimated to be $6 billion and gastric cancer kills over 700000 people per year globally. The prevalence of H. pylori infection remains high (> 50%) in much of the world, although the infection rates are dropping in some developed nations. The drop in H. pylori prevalence could be a double-edged sword, reducing the incidence of gastric diseases while increasing the risk of allergies and esophageal diseases. The list of diseases potentially caused by H. pylori continues to grow; however, mechanistic explanations of how H. pylori could contribute to extragastric diseases lag far behind clinical studies. A number of host factors and H. pylori virulence factors act in concert to determine which individuals are at the highest risk of disease. These include bacterial cytotoxins and polymorphisms in host genes responsible for directing the immune response. This review discusses the latest advances in H. pylori pathogenesis, diagnosis, and treatment. Up-to-date information on correlations between H. pylori and extragastric diseases is also provided.

Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment.

Helicobacter pylori (H. pylori) is a major cause of chronic gastritis and gastric ulcers and considerable evidence supports the notion that infection with this bacterium is also associated with gastric malignancy in addition to various other conditions including pulmonary, vascular and autoimmune disorders. Gastric juice infected with H. pylori might play an important role in upper respiratory tract infection. Although direct and/or indirect mechanisms might be involved in the association between H. pylori and upper respiratory tract diseases, the etiological role of H. pylori in upper respiratory tract disorders has not yet been fully elucidated. Although various studies over the past two decades have suggested a relationship between H. pylori and upper respiratory tract diseases, the findings are inconsistent. The present overview describes the outcomes of recent investigations into the impact of H. pylori on upper respiratory tract and adjacent lesions.

An association between Helicobacter pylori and upper respiratory tract disease: Fact or fiction?

Objective:To compare the efficacy of two treatment regimens among Helicobacter pylori stool antigen positive children suffering from resistant otitis media with effusion.Methods:The study comprised 258 children with bilateral otitis media with effusion; 134 were positive for H pylori stool antigen, and were equally and randomly allocated to the control group or study group. The control group received standard otitis media with effusion therapy (amoxicillin and clavulanate), while the study group received standard H pylori triple therapy (clarithromycin, metronidazole and lansoprazole).Results:In the control group, there was a marked clinical response to treatment in 33 of the 67 children (49.3 per cent). In the study group, there was a marked response in a significantly higher number of children (46 out of 67, 68.7 per cent). The 124 H pylori stool antigen negative children not included in the 2 aforementioned groups received amoxicillin and clavulanate, and a marked response in symptoms was evident in 98 of these children (79 per cent).Conclusion:H pylori infection may lead to resistance to traditional otitis media with effusion treatment in some cases. H pylori eradication is associated with a high cure rate.

Outcome evaluation of clarithromycin, metronidazole and lansoprazole regimens in Helicobacter pylori positive or negative children with resistant otitis media with effusion

ObjectiveTo investigate the potential correlation between Helicobacter pylori infection and otitis media with effusion (OME) risk in children.Data SourcesElectronic databases were searched, includi...

Association Between Helicobacter pylori Infection and Otitis Media With Effusion Risk in Children: A Systematic Review and Meta-analysis.

The association of helicobacter pylori infection with otitis media: a meta-analysis

OBJECTIVES To evaluate the presence of Helicobacter pylori (HP) in middle ear effusion from Chinese adult patients with otitis media with effusion (OME). METHODOLOGY A total of 60 aspiration samples collected from adult patients (ranging from 19 to 73 years old) were included in the study. The effusion samples aspirated from the patients' middle ears were analyzed with polymerase chain reaction (PCR) assay and cultured for 7 days under microaerobic conditions. Subsequently, Gram staining and urease testing were performed to identify HP. RESULTS Of the 60 middle ear effusion samples, 24 (40%) were shown to be HP-positive by PCR assay. Of these, seven specimens were confirmed HP-positive by both culture and urease test. CONCLUSIONS The present study clearly demonstrates the presence of HP in the middle ear effusion of some Chinese adult patients with OME. This finding suggests that HP may be involved in the etiology of OME. Additional studies are needed to investigate the exact role of HP in the pathogenesis of OME.

Helicobacter pylori may cause otitis media with effusion: a pilot study.

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Helicobacter pylori may cause otitis media with effusion: a pilot study.