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Gut. 2015 Sep;64(9):1353-67. doi: 10.1136/gutjnl-2015-309252. Epub 2015 Jul 17.

Kyoto global consensus report on Helicobacter pylori gastritis.

Author information

1
Department of Medicine, Jichi Medical University, Tochigi, Japan.
2
Translational Research Center for Gastrointestinal Disorders, University of Leuven, Leuven, Belgium.
3
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, Netherland.
4
Department of Medicine, Michael E DeBakery VA Medical Center, Baylor College of Medicine, Houston, USA.
5
Division of Applied Medicine, Institute of Medical Sciences, Aberdeen University, Aberdeen, UK.
6
National Defense Medical College, Tokorozawa, Japan.
7
Department of Gastroenterology, Kawasaki Medical School, Kurashiki, Japan.
8
Department of Cancer Preventive Medicine, Hokkaido University, Sapporo, Japan.
9
Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Japan.
10
Department of Gastroenterology, University of Magdeburg, Magdeburg, Germany.

Abstract

OBJECTIVE:

To present results of the Kyoto Global Consensus Meeting, which was convened to develop global consensus on (1) classification of chronic gastritis and duodenitis, (2) clinical distinction of dyspepsia caused by Helicobacter pylori from functional dyspepsia, (3) appropriate diagnostic assessment of gastritis and (4) when, whom and how to treat H. pylori gastritis.

DESIGN:

Twenty-three clinical questions addressing the above-mentioned four domains were drafted for which expert panels were asked to formulate relevant statements. A Delphi method using an anonymous electronic system was adopted to develop the consensus, the level of which was predefined as ≥80%. Final modifications of clinical questions and consensus were achieved at the face-to-face meeting in Kyoto.

RESULTS:

All 24 statements for 22 clinical questions after extensive modifications and omission of one clinical question were achieved with a consensus level of >80%. To better organise classification of gastritis and duodenitis based on aetiology, a new classification of gastritis and duodenitis is recommended for the 11th international classification. A new category of H. pylori-associated dyspepsia together with a diagnostic algorithm was proposed. The adoption of grading systems for gastric cancer risk stratification, and modern image-enhancing endoscopy for the diagnosis of gastritis, were recommended. Treatment to eradicate H. pylori infection before preneoplastic changes develop, if feasible, was recommended to minimise the risk of more serious complications of the infection.

CONCLUSIONS:

A global consensus for gastritis was developed for the first time, which will be the basis for an international classification system and for further research on the subject.

KEYWORDS:

FUNCTIONAL DYSPEPSIA; GASTRIC CANCER; GASTRITIS; HELICOBACTER PYLORI - GASTRITIS; HELICOBACTER PYLORI - TREATMENT

PMID:
26187502
PMCID:
PMC4552923
DOI:
10.1136/gutjnl-2015-309252
[Indexed for MEDLINE]
Free PMC Article

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