HIGHLIGHTS
- The consensus brought together 26 experts from all regions of Brazil, who developed 34 evidence-based recommendations to guide infection management in Brazil population.
- Removing the bacterium is recommended for all infected individuals and is crucial in cases of chronic gastritis, peptic ulcer disease, MALT lymphoma, and gastric precancerous conditions.
- The ¹³C-urea breath test is the non-invasive gold standard for diagnosis and treatment monitoring, while histology is the invasive gold standard for mucosal assessment.In response to increasing antimicrobial resistance, the consensus recommends 14-day treatments, emphasizing quadruple bismuth therapy and the use of P-CABs (such as vonoprazan) to maximize effectiveness.
- Eradication of H. pylori is crucial for the primary and secondary prevention of gastric cancer, particularly among first-degree relatives of patients with the disease and following resection of early tumors.
ABSTRACT
Background –
Helicobacter pylori infection remains highly prevalent, affecting approximately 40% of the global population. Individuals with infection continue to be at risk for its various clinical consequences, including chronic gastritis, peptic ulcer disease, and gastric cancer. Objective – The Brazilian Helicobacter pylori and Microbiota Study Group and the Brazilian Federation of Gastroenterology present the Fifth Brazilian Consensus on this topic, following the inaugural edition in 1995. Significant advances across various areas have emerged since the publication of the last consensus in 2018. These advances are particularly relevant to bacterial eradication, as treatment encounters mounting challenges due to rising antimicrobial resistance. Methods – For this update, five working groups were established to address: 1) epidemiology; 2) associated diseases and treatment indications; 3) diagnosis; 4) gastric cancer; and 5) treatment and microbiota. Conclusion – The groups developed 34 evidence-based recommendations to guide clinicians in managing this infection within the Brazilian population.
AUTOR
Luiz Gonzaga Vaz COELHO, Bruno Squárcio Fernandes SANCHES, Ismael MAGUILNIK, James Ramalho MARINHO, Sandro Rodrigues CHAVES, Ana Flávia P. RAMOS, Heinrich SEIDLER, Ricardo C. BARBUTI, Renato S. LABOISSIÈRE, Laércio Tenório RIBEIRO, Maria do Carmo F. PASSOS, Julio César de Soares VELOSO, Lucia Libanês C. BRAGA, Frederico Passos MARINHO, Helenice P. BREYER, Hoiti OKAMOTO, Jardel Soares CAETANO, Paulo Pimentel D’ASSUMPÇÃO, Leonardo Soares da SILVA, Gerson DOMINGUES, Raul Carlos WAHLE, Eliza Maria de BRITO, Marcela Tavares da Rocha LOURES, Joaquim Prado MORAES-FILHO, Décio CHINZON , Áureo Almeida DELGADO
