Helicobacter pylori is an organism that is a worldwide cause of significant morbidity and mortality. There has been a sea change in our understanding and hence diagnosis and treatment of this ubiquitous bacterium over the last few years and more is in the offing. Though it still affects over half the world's population, there has been an identification of genes and epigenetic motifs which can modify disease expression and cancer occurrence with Helicobacter infection. Newer diagnostic modalities like urine antibody analysis, immune-chromatographic culture methods, pepsinogen assays and micro-RNAdetection promise earlier identification of more virulent forms. Advances in endoscopy have also incorporated Chromo-endoscopy, Narrow Band Imaging, Confocal endomicroscopy and Raman spectroscopy for diagnosis of H. pylori infections with greater accuracy. Advent of genotype drug resistance assays and newer therapeutic regimens have afforded greater efficacy in eradicating this infection. An interesting area of research is novel drug delivery systems, like the gastro-retentive systems, which have increased efficacy of existing drugs against Helicobacter. Vaccine development is also underway with ongoing animal trials on EPIVAC vaccine among others, showing some benefits. Though there is still a long way to go, all these newer modalities hold out hope for the possibility of a reduction in the burden associated with this wide spread infection.
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