Helicobacter pylori is strongly associated with chronic active gastritis, peptic ulcer disease, and gastric carcinoma. Understanding the mode of transmission of H. pylori is essential to limit its spread and serious associated diseases. Most infections are acquired in childhood and some risk factors associated with childhood infection include poor sanitation, overcrowding, bed sharing, and lower socio-economic status. The theory of direct person-to-person spread is now generally accepted, but the route of transmission remains open to conjecture. The evidence linking H. pylori with peptic ulcer disease and low-grade MALToma is extremely strong. However, the association with gastro-oesophageal reflux disease, non-ulcer dyspepsia and its synergism with NSAIDs in the causation of ulcers remains controversial. The infection can be diagnosed by invasive (endoscopic) and non-invasive testing. Current therapy is highly effective in eradicating the organism.
