Current concepts of Helicobacter pylori infection

Helicobacter pylori infection is a major cause of chronic gastritis, which can progress to a more serious gastroduodenal disease, such as a peptic ulcer, gastric cancer, or gastric mucosa-associated lymphoid tissue. Typically acquired during childhood, H. pylori infection persists throughout life if left untreated, affecting nearly half of the world population, with prevalence varying based on geographic location and sanitation standards. The bacterium exhibits unique adaptations that enable colonization of the gastric epithelium in acidic environments. Its pathogenesis of H. pylori involves bacterial virulence factors, host immune interactions, and environmental influences, leading to varied disease outcomes. The established role of H. pylori in gastric cancer underscores the importance of screening and treatment. Diagnosis relies on invasive tests, such as endoscopy and the non-invasive tests including stool, breath and serological methods" with test selection based on patient history and resource availability. Standard treatments combine acid suppression with antibiotics and/or bismuth. However, rising antibiotic resistance poses a major challenge, emphasizing the need for antibiotic susceptibility testing, resistance surveillance, and improved antibiotic stewardship in managing H. pylori infections.