Helicobacter, audit, and ageing

BMJ 1998; 316 doi: (Published 16 May 1998) Cite this as: BMJ 1998;316:0

Until 1800 almost everybody was infected with Helicobacter pylori. Living without H pylori is a modern phenomenon of the developed world. Interestingly peptic ulcer disease and gastric cancer affecting the antrum and the body have been declining in precisely those parts of the world where H pylori colonisation has also declined. Meanwhile, gastro-oesophageal disease and its sequelae, including adenocarcinoma of the oesophagus, are increasing rapidly in several Western countries. In other words, as Martin Blaser explains (p 1507), the relation between H pylori and gastroduodenal disease is more complicated than you thought. …

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