한국인에서의 Helicobacter pylori 감염의 진단 및 치료 = Diagnosis and Treatment of Helicobacter pylori Infection in Korea

다국어 초록 (Multilingual Abstract)

Since the guidelines of the US National lnstitute of Health for Helicobacter pylori (H. pylori jinfection were produced in 1994, several recommendations for the management of the infection have been developed independently in European and Asian Pacific countrise. However, those are not identicatly use prevalence rate of H. pylori infeciton, incidence of gastric cancer, and regional economic status vary significantly in different localities. Until recently, there have been considerable confusions over the management of H. pylori infection. Therefore, it is urgent to develop our own consensus guidelines at the moment. In Febroary 1998, the Korean H. pylori Study Group organized a domestic consensus meeting and has made recommendations based on available evidences reported, after taking the mentioned regional characteristics into consideration. A number of diagnostic tests for the infection are available throughout the country. When endoscopy is clinically available, biopsy urease testing and histology are recommended as the tests of choice, Serological test is not mcommended at the moment because of its low sensitivity and especially low specificity reported in Korea. The urea breath test is more sensitive and specific noninvasive test than serological test, but it is not widely available yet All gastric and duodenal ulcer patients who are infected with H. pylori should be treated for H. pylori regardless of the stage of ulcer (active, complicated or scarring). Treatment is also recommended for the patients with endoscopic resection of early gastric cancer (EGC) and for the patients with 1ow- gastric mucosa-associated lymphoid tissue (MALT) lymphoma, although supporting evidence is limited. However, patients with family history of gastric cancer and patients with non-ulcer dyspepsia, gastritis or duodenitis are not the subjects for eradication. Asymptomatic persons and patients who want to be treated should not be tested and treated, either. It was concluded that there wasn't sufficient evidence that cure of H. pylori infection reduces the risk of gastric aadenocarcinoma or prevents the development of it. Therefore, eradication of H. pylori should not be attempted for the purpose of preventing development of gastric cancer. Post-treatment testing was not always recommended for all pati*ents. It is appropriate to confirm eradicatian and ulcer healing in patients with gastric ulcer, complicated duodenal ulcer, gastric MALT
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