Key Issues Associated with Helicobacter pylori Eradication.

Eradication of Helicobacter pylori causes improvement of gastric atrophy and intestinal metaplasia. Gastric acid secretion levels in corpus predominant gastritis increase after eradication. These changes can increase the risk of reflux esophagitis and low-dosage aspirin ulcers. Although eradication may reduce the overall risk of gastric cancer, a certain degree of risk remains, related to the extent of atrophy and intestinal metaplasia. Many post-eradication gastric cancers are the early depressed type, with low levels of epithelial atypia, and therefore can be difficult to distinguish endoscopically from benign erosion. Further research is required in this area.