The Effect of Helicobacter Pylori Eradication on NSAID-Induced Gastrointestinal Toxicity

Abstract

OBJECTIVE: To review the data to determine whether Helicobacter pylorieradication alters nonsteroidal antiinflammatory drug (NSAID)–induced gastrointestinal toxicity. DATA SOURCE: Literature accessed through MEDLINE from 1966 to May 2000 and abstracts of recently presented data at scientific meetings. DATA SYNTHESIS: NSAID use and H. pyloriinfection are independent risk factors for the development of gastrointestinal ulcers. An evaluation of the relationship between these two risk factors and the impact of H. pylorieradication on NSAID-induced gastrointestinal toxicity was conducted. CONCLUSIONS: H. pyloricolonization and NSAID use are independent risk factors for the development of gastrointestinal ulcers. The data regarding the interaction between these two risk factors in the development of gastrointestinal ulcers are conflicting. Eradication of H. pyloridoes not appear to decrease the risk of NSAID-induced gastrointestinal toxicity in the majority of patients. As there is little evidence to support a clear benefit of eradicating H. pyloriin patients requiring NSAID therapy, routine screening for and eradication of H. pyloriin these patients is not recommended.