Family-Based H. pylori Eradication Strategies

In comparison to population- or community-based approaches, the advantages of a whole-family approach are that it identifies and continues to treat people who are infected by H. pylori . When there is a high rate of infection in a population, as well as in a family, whose members have a significant stake, it is likely that these individuals will be motivated to become involved. Taking advantage of this method improves the management and monitoring of infected patients so that precancerous lesions can be detected earlier . The preliminary practice findings of a whole family-based approach suggest that patients and family members are highly satisfied with the treatment they receive and are highly compliant; therefore, this approach deserves further research and improvement . A concern with this approach is that it can lead to an overscreening of involved family members, which can lead to overdiagnosis. Noninvasive serological tests, urease breath tests, and stool antigen tests are all more cost effective, accessible, and effective than invasive serological tests, so these approaches are viable alternatives for testing and treating entire families whose members are at high risk of developing H. pylori infection . As a general rule, it is not recommended that individuals with asymptomatic infections of H. pylori be tested for infections, but in some cases, such as patients who require long-term nonsteroidal anti-inflammatory drug therapy or individuals with a family history of stomach cancer, this may be necessary . Patients with dyspepsia-like symptoms should not be routinely tested for H. pylori, nor should empiric eradication treatment be prescribed without testing for the presence of H. pylori.