Helicobacter, audit, and ageing

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. …