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Canadian Journal of Gastroenterology
Volume 16, Issue 1, Pages 57-62

Risks and Benefits of Helicobacter pylori Eradication: Current Status

Richard H Hunt,1 Carlo Fallone,2 Sander Veldhuyzen van Zanten,3 Phil Sherman,4 Fiona Smaill,1 Alan BR Thomson,5 and the Canadian Helicobacter Study Group

1Division of Gastroenterology, Department of Medicine, McMaster University, Hamilton, Ontario, Canada
2Division of Gastroenterology, Department of Medicine, McGill University, Montreal, Quebec, Canada
3Division of Gastroenterology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
4Division of Gastroenterology and Nutrition, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
5Division of Gastroenterology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada

Received 12 February 2001; Accepted 23 March 2001

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In patients with diseases known to be associated with Helicobacter pylori infection, such as peptic ulcer, treatment of the underlying infection is the standard of care. However, in most major consensus management guidelines, including those published in Canada, widespread testing for H pylori infection is not recommended. This practice is not encouraged because of insufficient evidence of cost-benefit in gastric cancer prevention, the potential for increases in antibiotic resistance and the controversial hypothesis of potential negative effects of eradication in certain clinical entities. For example, there is insufficient evidence to recommend against eradicating H pylori discovered in a patient with symptoms of gastroesophageal reflux disease. The management guidelines designed specifically in Canada should, therefore, continue to be applied, with H pylori diagnosed and treated in appropriately selected patients.