ORIGINAL ARTICLE
Guidelines for the management of Helicobacter pylori infection in Japan: 2016 Revised Edition
Mototsugu Kato,
Hiroyoshi Ota,
Masumi Okuda,
Shogo Kikuchi,
Kiichi Satoh,
Tadashi Shimoyama,
Hidekazu Suzuki,
Osamu Handa,
Takahisa Furuta,
Katsuhiro Mabe,
Kazunari Murakami,
Toshiro Sugiyama,
Naomi Uemura,
Shin'ichi Takahashi,
Corresponding Author
Mototsugu Kato
Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
Correspondence
Mototsugu Kato, Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Kawaramachi 18-16, Hakodate, Hokkaido, 041-8512, Japan.
Email: mkato1957@gmail.com
Search for more papers by this authorHiroyoshi Ota
Department of Clinical Laboratory Sciences, Shinshu University School of Medicine, Nagano, Hyogo, Japan
Search for more papers by this authorMasumi Okuda
Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
Search for more papers by this authorShogo Kikuchi
Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
Search for more papers by this authorKiichi Satoh
Department of Gastroenterology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan
Search for more papers by this authorTadashi Shimoyama
Aomori General Health Examination Center, Aomori, Japan
Search for more papers by this authorHidekazu Suzuki
Fellowship Training Center, Medical Education Center, Keio University School of Medicine, Tokyo, Japan
Search for more papers by this authorOsamu Handa
Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
Search for more papers by this authorTakahisa Furuta
Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
Search for more papers by this authorKatsuhiro Mabe
Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
Search for more papers by this authorKazunari Murakami
Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
Search for more papers by this authorToshiro Sugiyama
Department of Cancer Prevention and Therapeutics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
Search for more papers by this authorNaomi Uemura
Department of Gastroenterology, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
Search for more papers by this authorShin'ichi Takahashi
Department of Gastroenterology, Kosei Hospital, Tokyo, Japan
Search for more papers by this authorMototsugu Kato,
Hiroyoshi Ota,
Masumi Okuda,
Shogo Kikuchi,
Kiichi Satoh,
Tadashi Shimoyama,
Hidekazu Suzuki,
Osamu Handa,
Takahisa Furuta,
Katsuhiro Mabe,
Kazunari Murakami,
Toshiro Sugiyama,
Naomi Uemura,
Shin'ichi Takahashi,
Corresponding Author
Mototsugu Kato
Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
Correspondence
Mototsugu Kato, Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Kawaramachi 18-16, Hakodate, Hokkaido, 041-8512, Japan.
Email: mkato1957@gmail.com
Search for more papers by this authorHiroyoshi Ota
Department of Clinical Laboratory Sciences, Shinshu University School of Medicine, Nagano, Hyogo, Japan
Search for more papers by this authorMasumi Okuda
Department of Pediatrics, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
Search for more papers by this authorShogo Kikuchi
Department of Public Health, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan
Search for more papers by this authorKiichi Satoh
Department of Gastroenterology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan
Search for more papers by this authorTadashi Shimoyama
Aomori General Health Examination Center, Aomori, Japan
Search for more papers by this authorHidekazu Suzuki
Fellowship Training Center, Medical Education Center, Keio University School of Medicine, Tokyo, Japan
Search for more papers by this authorOsamu Handa
Department of Molecular Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan
Search for more papers by this authorTakahisa Furuta
Center for Clinical Research, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan
Search for more papers by this authorKatsuhiro Mabe
Department of Gastroenterology, National Hospital Organization Hakodate National Hospital, Hakodate, Hokkaido, Japan
Search for more papers by this authorKazunari Murakami
Department of Gastroenterology, Faculty of Medicine, Oita University, Oita, Japan
Search for more papers by this authorToshiro Sugiyama
Department of Cancer Prevention and Therapeutics, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama, Japan
Search for more papers by this authorNaomi Uemura
Department of Gastroenterology, Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan
Search for more papers by this authorShin'ichi Takahashi
Department of Gastroenterology, Kosei Hospital, Tokyo, Japan
Search for more papers by this authorAbstract
Background
Since “Helicobacter pylori (H. pylori) infection” was set as the indication in the Japanese Society for Helicobacter Research (JSHR) Guidelines 2009, eradication treatment for H. pylori gastritis is covered under insurance since 2013 in Japan, and the number of H. pylori eradication has rapidly increased. Under such circumstances, JSHR has made the third revision to the “Guidelines for diagnosis and treatment of H. pylori infection” for the first time in 7 years.
Methods
The Guideline Committee held 10 meetings. Articles published between the establishment of the 2009 Guidelines and March 2016 were reviewed and classified according to the evidence level; the statements were revised on the basis of this review. After inviting public comments, the revised statements were finalized using the Delphi method.
Results
There was no change in the basic policy that H. pylori infectious disease is an indication for eradication. Other diseases presumed to be associated with H. pylori infection were added as indications. Serum pepsinogen level, endoscopic examination, and X-ray examination were added to the diagnostic methods. The effects of 1-week triple therapy consisting of potassium-competitive acid blocker (P-CAB), amoxicillin, and clarithromycin have improved, and high eradication rates can also be expected with proton pump inhibitors (PPI) or P-CAB combined with amoxicillin and metronidazole. If the susceptibility test is not performed, the triple PPI or P-CAB/amoxicillin/metronidazole therapy should be chosen, because the PPI/amoxicillin/metronidazole combination demonstrated a significantly higher eradication rate than PPI/amoxicillin/clarithromycin. In the proposal for gastric cancer prevention, we divided gastric cancer prevention measures by age from adolescent to elderly, who are at an increased gastric cancer risk, and presented measures for gastric cancer prevention primarily based on H. pylori eradication.
Conclusion
We expect the revised guidelines to facilitate appropriate interventions for patients with H. pylori infection and accomplish its eradication and prevention of gastric cancer.
CONFLICT OF INTEREST
The authors disclose conflict of interest with the following companies. This study received lecture fees and/or payment of manuscripts from AstraZeneca KK, Eisai Co. Ltd., Otsuka Pharmaceutical Co., Ltd., Daiichi Sankyo Company, Takeda Company and scholarship grants from Astellas Pharma Inc, Abbott Japan Co. Ltd., Eisai Co. Ltd., Otsuka Pharmaceutical Co., Ltd., Daiichi Sankyo Company. Kikuchi S accepted fee for speaking from Otsuka Pharmaceutical Co., Ltd. (Tokyo, Japan).
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