The discovery of Helicobacter pylori infection in 1984 revolutionised the management of several common upper gastrointestinal diseases. However, some of the clinical practices that were adopted following discovery of this organism have become less appropriate over the intervening years. This article discusses five ‘myths and misconceptions’ that we believe have now emerged and which we argue need re-evaluation. Although the prevalence of H. pylori infection is decreasing in some developed countries, it remains a huge global problem and the most serious consequence of infection, gastric adenocarcinoma, is still a major cause of mortality. The epidemiology of H. pylori -related diseases is also changing and careful testing remains crucially important, especially in patients with peptic ulceration. Eradication of H. pylori infection has also become much more difficult over recent years as a result of the widespread acquisition of antibiotic resistance. Routine assessment of the success of eradication should therefore now be performed. Finally, there has been increased awareness about the role of H. pylori in the multistep pathway of gastric carcinogenesis, about the opportunities to prevent cancer development by eradicating this infection in some individuals and about detecting high-risk preneoplastic changes via endoscopic surveillance. The discovery of H. pylori was rightly honoured by the award of the Nobel prize for Physiology and Medicine in 2005. However, unless we re-evaluate and update the ways in which we manage H. pylori infection, much of the fantastic progress that has been made in this field of medicine may tragically be lost once again.

中文翻译：

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幽门螺杆菌感染管理中的误区和误解

1984 年幽门螺杆菌感染的发现彻底改变了几种常见上消化道疾病的治疗。然而，在发现这种生物体之后采用的一些临床实践在随后的几年中变得不那么合适了。本文讨论了我们认为现在已经出现并且我们认为需要重新评估的五个“神话和误解”。尽管在一些发达国家，幽门螺杆菌感染的流行率正在下降，但它仍然是一个巨大的全球性问题，感染最严重的后果胃腺癌仍然是导致死亡的主要原因。幽门螺杆菌相关疾病的流行病学也在发生变化，仔细检测仍然至关重要，尤其是在消化性溃疡患者中。根除 H. 近年来，由于抗生素耐药性的广泛获得，幽门螺杆菌感染也变得更加困难。因此，现在应该对根除成功进行例行评估。最后，人们越来越意识到幽门螺杆菌在胃癌发生的多步骤途径中的作用，通过根除某些个体的感染来预防癌症发展的机会，以及通过内窥镜监测检测高风险的癌前病变。H. pylori 的发现理所当然地获得了 2005 年诺贝尔生理学和医学奖。然而，除非我们重新评估和更新我们管理 H. pylori 感染的方法，否则许多已经取得的惊人进展在这个医学领域取得的成就可能会再次悲惨地失去。