Maastricht consensus-5: analytical review of statements

Yu.M. Stepanov, I.Ya. Budzak


This article analyzes the statements of Maastricht consensus-5 on H. pylori infection studying. There was shown the changes in approaches to diagnostics and treatment of H. pylori infection in previous Maastricht consensuses. H. pylori associated gastritis was considered to be an infection disease. There was also analyzed the relation between this infection and gatroduodenal pathology including functional dyspepsia, NSAID-gastropathy and others. The paper deals with up-to-date approaches to diagnostics of H. pylori infection with determination of the most optimal diagnostic method in different situations. The approaches to antihelicobacter therapy were analyzed. The special attention was paid to dependence of modern therapeutic schemes of helicobacteriosis therapy on H. pylori resistance to key antibiotics. There was confirmed the importance of H. pylori eradication for prevention of precancerous changes in the stomach. The increased interest of researchers to non-helicobacter flora in the stomach was shown. There was regarded an important role of probiotics in antihelicobacter therapy.


H. pylori infection; diagnostics; treatment; prevention of precancerous changes in the stomach; Maastricht consensus-5


European Helicobacter Pylori Study Group. Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. Gut. 1997 Jul;41(1):8-13. PMC1027220.

Malfertheiner P, Mégraud F, O’Morain C, et al. European Helicobacter Pylori Study Group. Current concepts in the management of Helicobacter pylori infection — the Maastricht 2-2000 Consensus Report. Aliment Pharmacol Ther. 2002 Feb;16(2):167-80. doi: 10.1046/j.1365-2036.2002.01169.x.

Malfertheiner P, Mégraud F, O’Morain C, et al. European Helicobacter Pylori Study Group. Current concepts in the management of Helicobacter pylori infection: the Maastricht III Consensus Report. Gut. 2007 Jun;56(6):772-81. doi: 10.1136%2Fgut.2006.101634.

Malfertheiner P, Mégraud F, O’Morain C, et al. Management of Helicobacter pylori infection — the Maastricht IV/Florence Consensus Report. Gut. 2012 May;61(5):646-64. doi: 10.1136/gutjnl-2012-302084.

Malfertheiner P, Mégraud F, O’Morain C et al. European Helicobacter and Microbiota Study Group and Consensus panel. Management of Helicobacter pylori infection — the Maastricht V/Florence Consensus Report. Gut. 2017 Jan;66(1):6-30. doi: 10.1136/gutjnl-2016-312288.

Sugano K, Tack J, Kuipers EJ, et al. Kyoto global consensus report on Helicobacter pylori gastritis. Gut. 2015 Sep;64(9):1353-67. doi: 10.1136/gutjnl-2015-309252.

Ford AC, Qume M, Moayyedi P, et al. Helicobacter pylori “test and treat” or endoscopy for managing dyspepsia: an individual patient data meta-analysis. Gastroenterology. 2005;128:1838-44.

Niv Y, Niv G, Koren R. 13C-urea breath test for diagnosis of Helicobacter pylori infection in the elderly. Dig Dis Sci. 2004;49:1840-4. doi: 10.1007/s10620-004-9581-4.

Malfertheiner P. The intriguing relationship of Helicobacter pylori infection and acid secretion in peptic ulcer disease and gastric cancer. Dig Dis. 2011;29:459-64. doi: 10.1159/000332213.

Fukuchi T, Ashida K, Yamashita H, et al. Influence of cure of Helicobacter pylori infection on gastric acidity and gastroesophageal reflux: study by 24-h pH monitoring in patients with gastric or duodenal ulcer. J Gastroenterol. 2005;40:350-60. doi: 10.1007/s00535-004-1552-1.

Lundell L, Havu N, Miettinen P, et al. Changes of gastric mucosal architecture during long-term omeprazole therapy: results of a randomized clinical trial. Aliment Pharmacol Ther. 2006;23:639-47. doi: 10.1111/j.1365-2036.2006.02792.x.

Qian B, Ma S, Shang L, et al. Effects of Helicobacter pylori eradication on gastroesophageal reflux disease. Helicobacter. 2011;16(4):255-65. doi: 10.1111/j.1523-5378.2011.00846.x.

Moayyedi P, Bardhan C, Young L, et al. Helicobacter pylori eradication does not exacerbate reflux symptoms in gastroesophageal reflux disease. Gastroenterology. 2001;121:1120-6. doi: 10.1053/gast.2001.29332.

Suzuki H, Moayyedi P. Helicobacter pylori infection in functional dyspepsia. Nat Rev Gastroenterol & Hepatol. 2013;10:168-74. doi: 10.1038/nrgastro.2013.9.

Huang JQ, Sridhar S, Hunt RH. Role of Helicobacter pylori infection and non-steroidal anti-inflammatory drugs in peptic-ulcer disease: a meta-analysis. Lancet. 2002;359:14-22. doi: 10.1016/S0140-6736(02)07273-2.

Sostres C, Carrera-Lasfuentes P, Benito R, et al. Peptic ulcer bleeding risk. The role of Helicobacter pylori infection in NSAID/low-dose aspirin users. Am J Gastroenterol. 2015;110:684-9. doi: 10.1038/ajg.2015.98.

Qu X-H, Huang X-L, Xiong P, et al. Does Helicobacter pylori infection play a role in iron deficiency anemia? A meta-analysis. World J Gastroenterol. 2010;16:886-96. doi: 10.3748/wjg.v16.i7.886.

Provan D, Stasi R, Newland AC, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010;115:168-86. doi: 10.1182/blood-2009-06-225565.

Stabler SP. Vitamin B12 deficiency. N Engl J Med. 2013;368:2041-2. doi: 10.1056/NEJMc1304350.

Nakamura S, Sugiyama T, Matsumoto T, et al. Long-term clinical outcome of gastric MALT lymphoma after eradication of Helicobacter pylori: a multicenter cohort follow-up study of 420 patients in Japan. Gut 2012;61:507-13. doi: 10.1136/gutjnl-2011-300495.

Capelle LG, de Vries AC, Looman CWN, et al. Gastric MALT lymphoma: epidemiology and high adenocarcinoma risk in a nation-wide study. Eur J Cancer. 2008;44:2470-6. doi: 10.1016/j.ejca.2008.07.005.

Bu XL, Yao XQ, Jiao SS, et al. A study on the association between infectious burden and Alzheimer’s disease. Eur J Neurol 2015;22:1519-25. doi: 10.1111/ene.12477.

Bu XL, Wang X, Xiang Y, et al. The association between infectious burden and Parkinson’s disease: a case-control study. Parkinsonism Relat Disord. 2015;21:877-81. doi: 10.1016/j.parkreldis.2015.05.015.

Lane JA, Murray LJ, Harvey IM, et al. Randomised clinical trial: Helicobacter pylori eradication is associated with a significantly increased body mass index in a placebo-controlled study. Aliment Pharmacol Ther. 2011;33:922-9. doi: 10.1111/j.1365-2036.2011.04610.x.

Ferwana M, Abdulmajeed I, Alhajiahmed A, et al. Accuracy of urea breath test in Helicobacter pylori infection: meta-analysis. World J Gastroenterol. 2015;21:1305-14. doi: 10.3748/wjg.v21.i4.1305.

Gisbert JP, de la Morena F, Abraira V. Accuracy of monoclonal stool antigen test for the diagnosis of H. pylori infection: a systematic review and meta-analysis. Am J Gastroenterol. 2006;101:1921-30. doi: 10.1111/j.1572-0241.2006.00668.x.

Duggan AE, Elliott C, Logan RF. Testing for Helicobacter pylori infection: validation and diagnostic yield of a near patient test in primary care. BMJ. 1999;319:1236-9. PMC 28273.

Malfertheiner P. Diagnostic methods for H. pylori infection: choices, opportunities and pitfalls. United European Gastroenterol J. 2015;3:429-31. doi: 10.1177/2050640615600968.

Tongtawee T, Dechsukhum C, Leeanansaksiri W, et al. Improved detection of Helicobacter pylori infection and premalignant gastric mucosa using “site specific biopsy”: a randomized control clinical trial. Asian Pac J Cancer Prev. 2016;16:8487-90. doi: 10.7314/APJCP.2015.16.18.8487.

Dinis-Ribeiro M, Areia M, de Vries AC, et al. Management of precancerous conditions and lesions in the stomach (MAPS): guideline from the European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter Study Group (EHSG), European Society of Pathology (ESP), and the Sociedade Portuguesa. Endoscopy. 2012;44:74-94. doi: 10.1055%2Fs-0031-1291491.

Thung I, Aramin H, Vavinskaya V, et al. Review article: the global emergence of Helicobacter pylori antibiotic resistance. Aliment Pharmacol Ther. 2016;43:514-33. doi: 10.1111/apt.13497.

Ince AT, Tozlu M, Baysal B, et al. Yields of dual therapy containing high-dose proton pump inhibitor in eradication of H. pylori positive dyspeptic patients. Hepatogastroenterology. 2014 Jul-Aug;61(133):1454-8. PMID: 25436324.

Srinarong C, Siramolpiwat S, Wongchaum A, et al. Improved eradication rate of standard triple therapy by adding bismuth and probiotic supplement for Helicobacter pylori treatment in Thailand. Asian Pac J Cancer Prev. 2014;15:9909-13. doi: 10.7314/APJCP.2014.15.22.9909.

O’Morain C, Borody T, Farley A, et al. Efficacy and safety of single-triple capsules of bismuth biskalcitrate, metronidazole and tetracycline, given with omeprazole, for the eradication of Helicobacter pylori: an international multicentre study. Aliment Pharmacol Ther. 2003;17:415-20. doi: 10.1046/j.1365-2036.2003.01434.x.

McNicholl AG, Linares PM, Nyssen OP, et al. Meta-analysis: esomeprazole or rabeprazole vs. first-generation pump inhibitors in the treatment of Helicobacter pylori infection. Aliment Pharmacol Ther. 2012;36:414-25. doi: 10.1111/j.1365-2036.2012.05211.x.

Rodríguez-Torres M, Salgado-Mercado R, Ríos-Bedoya CF, et al. High eradication rates of Helicobacter pylori infection with first- and second-line combination of esomeprazole, tetracycline, and metronidazole in patients allergic to penicillin. Dig Dis Sci. 2005;50:634-39. doi: 10.1007/s10620-005-2549-1.

Bornschein J, Selgrad M, Warnecke M, et al. H. pylori infection is a key risk factor for proximal gastric cancer. Dig Dis Sci 2010;55(11):3124-31. doi: 10.1007/s10620-010-1351-x.

Lee YC, Chiang TH, Chou CK, et al. Association between Helicobacter pylori eradication and gastric cancer incidence: a systematic review and meta-analysis. Gastroenterology 2016;150:1113-1124.e5. doi: 10.1053/j.gastro.2016.01.028.

Bouvard V, Baan R, Straif K, et al. A review of human carcinogens — part B: biological agents. Lancet Oncol. 2009;10:321-2. doi: org/10.1016/S1470-2045(09)70096-8.

Kong YJ, Yi HG, Dai JC, et al. Histological changes of gastric mucosa after Helicobacter pylori eradication: a systematic review and meta-analysis. World J Gastroenterol. 2014;20:5903-11. doi: 10.3748%2Fwjg.v20.i19.5903.

Isajevs S, Liepniece-Karele I, Janciauskas D, et al. Gastritis staging: interobserver agreement by applying OLGA and OLGIM systems. Virchows Arch. 2014;464:403-7. doi: 10.1007/s00428-014-1544-3.

Delgado S, Cabrera-Rubio R, Mira A, et al. Microbiological survey of the human gastric ecosystem using culturing and pyrosequencing methods. Microb Ecol. 2013;65:763-72. doi:10.1007/s00248-013-0192-5.

Eun CS, Kim BK, Han DS, et al. Differences in gastric mucosal microbiota profiling in patients with chronic gastritis, intestinal metaplasia, and gastric cancer using pyrosequencing methods. Helicobacter. 2014;19:407-16. doi: 10.1111/hel.12145.

Segura-López FK, Güitrón-Cantú A, Torres J. Association between Helicobacter spp. infections and hepatobiliary malignancies: a review. World J Gastroenterol. 2015;21:1414-23. do: 10.3748/wjg.v21.i5.1414.

Zhang M-M, Qian W, Qin Y-Y, et al. Probiotics in Helicobacter pylori eradication therapy: a systematic review and meta-analysis. World J Gastroenterol. 2015;21:4345-57. doi: 10.3748%2Fwjg.v21.i14.4345.

Lv Z, Wang B, Zhou X, et al. Efficacy and sa fety of probiotics as adjuvant agents for Helicobacter pylori infection: a meta-analysis. Exp Ther Med 2015;9:707-16. doi: 10.3892/etm.2015.2174.

Szajewska H, Horvath A, Piwowarczyk A. Meta-analysis: the effects of Saccharomyces boulardii supplementation on Helicobacter pylori eradication rates and side effects during treatment. Aliment Pharmacol Ther. 2010;32(9):1069-79. doi: 10.1111/j.1365-2036.2010.04457.x.



  • There are currently no refbacks.

Copyright (c) 2017 GASTROENTEROLOGY

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.


© Publishing House Zaslavsky, 1997-2017


 Яндекс.МетрикаSeo анализ сайта Рейтинг