Gastrointestinal infection with the bacterium Helicobacter pylori (H. pylori) is ubiquitous, with a global prevalence of about 50% of the adult population. It is more prevalent among lower socio-economic groups and in developing countries.
The great majority of infected individuals remain symptomless, but infection predisposes to chronic gastritis, gastrointestinal ulceration and gastric cancer.
In the palliative care setting, patients commencing NSAID therapy (at least those with a longer life expectancy and/or a longer expected duration of treatment) should be screened for H. pylori infection, particularly if they have a history of dyspepsia or ulceration. Eradication of infection probably improves the safety profile of the NSAID.
Woodruff R. Palliative medicine evidence-based symptomatic and supportive care for patients with advanced cancer. Fourth edition. Oxford University Press, 2004. (p. 464)