Abstract

Infection with Helicobacter pylori has been designated a cause of human cancer by the International Agency for Research on Cancer (part of the World Health Organization).1 The infection, which affects 30-50% of adults in Europe and over 80% in parts of the developing world, is the commonest cause of chronic non-atrophic gastritis, which, if severe and prolonged, can lead to loss of gastric glands (atrophic gastritis) and intestinal metaplasia: both markedly increase the risk of developing gastric cancer.1^,2 H. pylori infection appears, by itself, capable of causing gastric mucosal atrophy,3 and there is some evidence that prolonged reduction in acid secretion, whether induced by disease or drugs, might accelerate this change.4^,5 These observations pose difficult dilemmas for doctors treating patients with gastric disorders, especially those needing long-term treatment with potent antisecretory drugs.