Abstract

ISAZA-GOMEZ, Esteban et al. Controversies in surgery: Eradication of Helicobacter pylori. Therapy for all or according to usual indications?. rev. colomb. cir. [online]. 2020, vol.35, n.4, pp.665-674.  Epub Feb 15, 2021. ISSN 2011-7582.  https://doi.org/10.30944/20117582.563.

Helicobacter pylori (H. pylori) infection is the most frequent chronic bacterial infection in humans, affecting 50% of the world population, and at least 80% of the Colombian population. This bacteria has been recognized for more than 15 years as a type I carcinogen. According to the indications of the "Maastricht V" consensus, this infection should be sought and treated in patients with: active peptic ulcer, MALT lymphoma (for its acronym Mucosa associated lymphoid tissue), early gastric cancer, purpura who present with chronic dyspeptic symptoms and chronic users of NSAIDs. Due to the role it plays in the pathophysiology of gastric cancer, the initiative was born to carry out an active search for H. pylori and eradicate it in all people, including those asymptomatic in countries with a high incidence of this neoplasia.

There are various publications around the world that suggest the effectiveness of this treatment and the positive impact on the course and progression of the disease, especially in the earliest stages of the infection, since the more advanced stages have less encouraging results regarding progression to malignancy. However, other authors highlight the growing problem of bacterial resistance that we are currently facing and demonstrate that the statistical weight and the different analyzes of the currently available studies have little validity to give an extended recommendation to the asymptomatic patient. It is suggested that perhaps inappropriate strategies to manage this public health situation are being used, since we are focused on impacting each individual with complex antibiotic therapies, instead of the general population with public health policies.

Keywords : Helicobacter pylori; stomach neoplasms; stomach ulcer; mucosa-associated lymphoid tissue lymphoma; anti-bacterial agents; drug resistance, bacterial.

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