The effect of helicobacter pylori eradication on NSAID-induced gastrointestinal toxicity

OBJECTIVE: To review the data to determine whether Helicobacter pylori eradication alters nonsteroidal antiinflammatory drug (NSAID)-induced gastrointestinal toxicity. DATA SOURCE: Literature accessed through MEDLINE from 1966 to May2000 and abstracts of recently presented data at scientific meetings. DATA SYNTHESIS: NSAID use and H. pylon infection 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. pylori eradication on NSAID-induced gastrointestinal toxicity was conducted. CONCLUSIONS: H. pylori colonization 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. pylori does 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. pylori in patients requiring NSAID therapy, routine screening for and eradication of H. pylori in these patients is not recommended.