Problemi correnti
Helicobacter pylori tra “Nelson” ed EBM
HELICOBACTER PYLORI: BETWEEN “NELSON TEXTBOOK” AND EVIDENCE-BASED MEDICINE
ANNALISA CACCIOLA1, CRISTINA COCUCCIO1, ELEONORA DI TOMMASO1, SIMONA FARACI2, GIUSEPPE LIOTTA3, ANTONIO MUSOLINO1, GIUSEPPE PAGANO4, GIUSEPPE VIENI1
1Specializzandi in Pediatria, Università di Messina
2Medico Laureato presso l’Università di Messina
3Specializzando in Pediatria, Università di Palermo
4Specialista in Pediatria, Università di Messina
Settembre 2005 - pagg. 457 -463
Abstract
The Authors describe a clinical case which leads to 4 questions: a) Can Helicobacter pylori
(Hp) cause acute abdominal pain? b) If yes, which is the most accurate test to identify Hp? c)
If Hp is isolated, should it be eradicated? d) What is the evidence based therapy in order to
eradicate Hp?
The Authors try to answer these 4 questions both by checking an updated edition of a Pediatrics
textbook and the Cochrane Library and by critically analysing the primary literature
published on PubMed. They conclude that Hp can cause acute abdominal pain but only
when it causes a gastric ulcer. The most accurate test is the fecal antigen test. Hp eradication
should be pursued only when gastric ulcer is present, using the association of 2 antibiotics and
omeprazole.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Opekun AR, Ginger MA, Denyes SM, et al.
Helicobacter pylori infection in children of
Texas. J Pediatr Gastroenterol Nutr 2000; 31:
405-10.
2. Macarthur C, Saunders N, Feldman W. Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain in children. JAMA 1995;273:729-34
3. Singh M, Prasad KN, Yachha SK, et al. Genotypes of Helicobacter pylori in children with upper abdominal pain. J Gastroenterol Hepatol 2003;18:1018-23.
4. Jahav J, Fradkin A, Weisselberg B, et al. Relevance of CagA positivity to clinical course of Helicobacter pylori infection in children. J Clin Microbiol 2000;38:3534-7.
5. Bode G, Rothenbacher D, Brenner H, Adler G. Helicobacter pylori and abdominal symptoms: a population-based study among preschool children in southern Germany. Paediatrics 1998;101:634-7.
6. Macarthur C, Saunders N, Feldman W, et al. Helicobacter pylori and childhood recurrent abdominal pain: community based case-control study. BMJ 1999;319:822-3.
7. Bode G, Brenner H, Adler G, Rothenbacher D. Recurrent abdominal pain in children: evidence from a population-based study that social and familial factors play a major role but not Helicobacter pylori infection. J Psychosom Res 2003;54:417-21.
8. Rasquin-Weber A, Hyman PE, Cucchiara S, et al. Childhood functional gastrointestinal disorders. GUT 1999; 45(Suppl.II):II60-II68.
9. Sabbi T, De Angelis P, Colistro F, et al. Efficacy of noninvasive tests in the diagnosis of Helicobacter pylori infection in pediatric patients. Arch Pediatr Adolesc Med 2005;159: 238-41.
10. Kato S, Nakayama K, Minoura T, et al. Comparison between the 13C-urea breath test and stool antigen test for the diagnosis of childhood Helicobacter pylori infection. J Gastroenterol 2004;39:1045-50.
11. De Giacomo C, Valdambrini V, Lizzoli F, et al. A population-based survey on gastrointestinal tract symptoms and Helicobacter pylori infection in children and adolescents. Helicobacter 2002;7:356-63.
12. Camargo MC, Yepez MC, Ceron C, et al. Age at acquisition of Helicobacter pylori infection: comparison of two areas with contrasting risk of gastric cancer. Helicobacter 2004;9:262- 270.
13. Oderda G, Rapa A, Bona G. A sistematic review of Helicobacter pylori eradication treatment schedules in children. Alim Pharmacol Ther 2000;14:59-66.
14. Tindberg Y, Casswall TH, Blennow M, et al. Helicobacter pylori eradication in children and adolescentes by a once daily 6-day treatment with or without a proton pump inhibitor in a double-blind randomizedd trial. Aliment Pharmacol Ther 2004;20:295-302.
15. Oderda G, Marinello D, Lerro P, et al. Dual vs triple therapy for childhood Helicobacter pylori gastritis: a double-blind randomized multicentre trial. Helicobacter 2004; 9:293-301.
16. Gottrand F, Kalach N, Spyckerelle C, et al. Omeprazole combined with amoxicillin and clarithromycin in the eradication of Helicobacter pylori in children with gastritis: a prospective randomized double-blind trial. J Pediatr 2001;139:664-8.
17. Bakir T, Can G, Erkul S, Siviloglu C. Stomach cancer history in the siblings of patients with gastric carcinoma. Eur J Cancer Prev 2000;9:401-8.
18. El Omar E, Oien K, Murray L, et al. Increased prevalence of precancerous changes in relatives of gastric cancer patients: critical role of Helicobacter pylori. Gastroenterology 2000;118:22-30.
19. Rothenbacher D, Winkler M, Gonser T, et al. Role of infected parents in transmission of Helicobacter pylori to their children. Pediatr Infect Dis J 2002;21:674-9.
20. Blaser MJ, Chyou PH, Nomura A. Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res 1995;55:562-5.
21. Klein PD, Gilman HR, Leon-Barua R, et al. The epidemiology of Helicobacter pylori in Peruvian children between 6 and 30 months of age. Gastroenterology 1994;89: 2196-200.
22. Malaty HM, Graham DY, Wattigney WA, et al. Natural history of Helicobacter pylori infection in childhood: 12-year follow-up cohort study in a biracial community. Clin Infect Dis 1999;28:279.82.
23. Magistà AM, Ierardi E, Castellaneta S, et al. Helicobacter pylori status and symptoms assessment two years after eradication in pediatric patients from a high prevalence area. JPGN 2005;40:312-8.
2. Macarthur C, Saunders N, Feldman W. Helicobacter pylori, gastroduodenal disease, and recurrent abdominal pain in children. JAMA 1995;273:729-34
3. Singh M, Prasad KN, Yachha SK, et al. Genotypes of Helicobacter pylori in children with upper abdominal pain. J Gastroenterol Hepatol 2003;18:1018-23.
4. Jahav J, Fradkin A, Weisselberg B, et al. Relevance of CagA positivity to clinical course of Helicobacter pylori infection in children. J Clin Microbiol 2000;38:3534-7.
5. Bode G, Rothenbacher D, Brenner H, Adler G. Helicobacter pylori and abdominal symptoms: a population-based study among preschool children in southern Germany. Paediatrics 1998;101:634-7.
6. Macarthur C, Saunders N, Feldman W, et al. Helicobacter pylori and childhood recurrent abdominal pain: community based case-control study. BMJ 1999;319:822-3.
7. Bode G, Brenner H, Adler G, Rothenbacher D. Recurrent abdominal pain in children: evidence from a population-based study that social and familial factors play a major role but not Helicobacter pylori infection. J Psychosom Res 2003;54:417-21.
8. Rasquin-Weber A, Hyman PE, Cucchiara S, et al. Childhood functional gastrointestinal disorders. GUT 1999; 45(Suppl.II):II60-II68.
9. Sabbi T, De Angelis P, Colistro F, et al. Efficacy of noninvasive tests in the diagnosis of Helicobacter pylori infection in pediatric patients. Arch Pediatr Adolesc Med 2005;159: 238-41.
10. Kato S, Nakayama K, Minoura T, et al. Comparison between the 13C-urea breath test and stool antigen test for the diagnosis of childhood Helicobacter pylori infection. J Gastroenterol 2004;39:1045-50.
11. De Giacomo C, Valdambrini V, Lizzoli F, et al. A population-based survey on gastrointestinal tract symptoms and Helicobacter pylori infection in children and adolescents. Helicobacter 2002;7:356-63.
12. Camargo MC, Yepez MC, Ceron C, et al. Age at acquisition of Helicobacter pylori infection: comparison of two areas with contrasting risk of gastric cancer. Helicobacter 2004;9:262- 270.
13. Oderda G, Rapa A, Bona G. A sistematic review of Helicobacter pylori eradication treatment schedules in children. Alim Pharmacol Ther 2000;14:59-66.
14. Tindberg Y, Casswall TH, Blennow M, et al. Helicobacter pylori eradication in children and adolescentes by a once daily 6-day treatment with or without a proton pump inhibitor in a double-blind randomizedd trial. Aliment Pharmacol Ther 2004;20:295-302.
15. Oderda G, Marinello D, Lerro P, et al. Dual vs triple therapy for childhood Helicobacter pylori gastritis: a double-blind randomized multicentre trial. Helicobacter 2004; 9:293-301.
16. Gottrand F, Kalach N, Spyckerelle C, et al. Omeprazole combined with amoxicillin and clarithromycin in the eradication of Helicobacter pylori in children with gastritis: a prospective randomized double-blind trial. J Pediatr 2001;139:664-8.
17. Bakir T, Can G, Erkul S, Siviloglu C. Stomach cancer history in the siblings of patients with gastric carcinoma. Eur J Cancer Prev 2000;9:401-8.
18. El Omar E, Oien K, Murray L, et al. Increased prevalence of precancerous changes in relatives of gastric cancer patients: critical role of Helicobacter pylori. Gastroenterology 2000;118:22-30.
19. Rothenbacher D, Winkler M, Gonser T, et al. Role of infected parents in transmission of Helicobacter pylori to their children. Pediatr Infect Dis J 2002;21:674-9.
20. Blaser MJ, Chyou PH, Nomura A. Age at establishment of Helicobacter pylori infection and gastric carcinoma, gastric ulcer, and duodenal ulcer risk. Cancer Res 1995;55:562-5.
21. Klein PD, Gilman HR, Leon-Barua R, et al. The epidemiology of Helicobacter pylori in Peruvian children between 6 and 30 months of age. Gastroenterology 1994;89: 2196-200.
22. Malaty HM, Graham DY, Wattigney WA, et al. Natural history of Helicobacter pylori infection in childhood: 12-year follow-up cohort study in a biracial community. Clin Infect Dis 1999;28:279.82.
23. Magistà AM, Ierardi E, Castellaneta S, et al. Helicobacter pylori status and symptoms assessment two years after eradication in pediatric patients from a high prevalence area. JPGN 2005;40:312-8.
Corrispondenza: giuseppevieni@libero.it