International Journal of Gerontology
Volume 2, Issue 4 , Pages 145-153, December 2008

Helicobacter Pylori Infection in the Elderly

  • Jyh-Ming Liou

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • ,
  • Jaw-Town Lin

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
    • ,
  • Yi-Chia Lee

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Division of Biostatistics, Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taipei, Taiwan
    • ,
  • Chun-Ying Wu

      Affiliations

    • Department of Internal Medicine, Veteran General Hospital, Taichung, Taiwan
    • ,
  • Ming-Shiang Wu

      Affiliations

    • Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
    • Corresponding Author InformationCorrespondence to: Professor Ming-Shiang Wu, Department of Internal Medicine, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, Taiwan

Accepted 15 August 2008.

Article Outline

SUMMARY 

The elderly often seek medical attention because of gastroduodenal diseases. Helicobacter pylori (H. pylori) infection is associated with several gastroduodenal diseases and its prevalence increases with age worldwide. It is estimated that 10–15% of infected patients will have peptic ulcer disease and 1% of patients will have gastric cancer or mucosa-associated lymphoid tissue lymphoma. Notably, the most severe clinical outcomes, i.e., gastric cancer and complicated peptic ulcer diseases, usually occur in elderly patients. Thus the test-and-treatment strategy is not recommended for elderly patients with uninvestigated dyspepsia. However, biopsy specimens for the rapid urease test and histology should be taken from both the antrum and corpus to increase the detection rate in elderly patients, especially in those with atrophic gastritis. The urea breath test may increase the detection rate if the rapid urease test or histology are negative in elderly patients with atrophic gastritis. Standard triple therapy and sequential therapy can achieve satisfactory eradication rates for H. pylori in elderly patients. Elderly patients with peptic ulcers may have a similar benefit from treatment of H. pylori infection as non-elderly patients. Eradication of H. pylori infection may also lead to improvement in histologic grading of gastritis, but the risk of gastric cancer cannot be completely reduced, especially in patients with existing premalignant lesions.

Key Words:  aged , gastrointestinal diseases , geriatrics , Helicobacter pylori

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PII: S1873-9598(09)70002-X

doi:10.1016/S1873-9598(09)70002-X

International Journal of Gerontology
Volume 2, Issue 4 , Pages 145-153, December 2008

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