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Invited Commentary

Michael W. Mulholland, MD, PhD
Arch Surg. 1997;132(4):434. doi:10.1001/archsurg.1997.01430280108018.
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The description of H pylori in 1983 as a cause of peptic ulcer was a signal event in gastroenterology, and the ensuing decade has provided a vast amount of data relating to this organism. The evidence relating H pylori to peptic ulcer is multifaceted and unequivocal.

The frequency of H pylori infection varies geographically. In the United States, H pylori infection increases from approximately 10% in patients at age 20 years to 50% in the sixth decade of life. In Asia, childhood infection is more common and the prevalence of H pylori infestation in young adults correspondingly higher. In this issue of the Archives, Lee et al report a 59% seropositivity rate for 136 adults without symptoms in Taiwan. For epidemiological studies, the most appropriate method of detection of H pylori is serological testing. Serum levels of IgG and IgA antibodies are significantly higher in H pylori—positive patients than in


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