Vth Brazilian Consensus Conference on Helicobacter pylori infection - Consensus highlights

Sep 23, 2026

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Helicobacter pylori infection remains highly prevalent, affecting about 40% of the global population, and leads to chronic gastritis, peptic ulcer disease, and gastric cancer risk. The Fifth Brazilian Consensus was developed by the Brazilian Helicobacter pylori and Microbiota Study Group with the Brazilian Federation of Gastroenterology, building on earlier editions and major advances since 2018. Five working groups produced 34 evidence-based recommendations to support Brazilian clinicians in eradication, diagnosis, associated diseases, gastric cancer prevention, and treatment selection amid rising antimicrobial resistance.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages43

Reading Time1 h 48 min

AccessFree to download

Consensus highlights

Key recommendations for infection management

Diagnosis and monitoring standards

Treatment strategies amid antimicrobial resistance

Prevention of gastric cancer and clinical relevance

Abstract

Background

Objective

Methods

Conclusion

Introduction

Epidemiology and clinical consequences

Rationale for an updated national consensus

CONSENSUS HIGHLIGHTS • The consensus brought together 26 experts from all regions of Brazil, who developed 34 evidence-based recommendations to guide infection management in Brazil population. • Removing the bacterium is recommended for all infected individuals and is crucial in cases of chronic gastritis, peptic ulcer disease, MALT lymphoma, and gastric precancerous conditions. • The ¹³C-urea breath test is thenon-invasive gold standard for diagnosis and treatment monitoring, while histology is the invasive gold standard for mucosal assessment. • In response to increasing antimicrobial resistance, the consensus recommends 14-day treatments, emphasizing quadruple bismuth therapy and the use of P-CABs (such as vonoprazan) to maximize effectiveness. • Eradication of H. pylori is crucial for the primary and secondary prevention of gastric cancer, particularly among first-degree relatives of patients with the disease and following resection of early tumors. Received: 21 March 2026 Accepted: 05 May 2026 Declared conflict of interest of all authors: Coelho LGV has served as speaker and advisory board member of Takeda and EMS. Sanches BSF has served as speaker of EMS. Barbuti RC has served as speaker of Biosintética, Aché, and EMS. Passos MCF has served as speaker and advisory board member of Abbott, Aché, Apsen, Mantecorp, and Takeda. Disclosure of funding: none Declaration of use of artificial intelligence: none Data availability statement: not applicable – the study did not use research data Corresponding author: Luiz Gonzaga Vaz Coelho. Email: [lcoelho22@gmail.com](lcoelho22@gmail.com) Associate editor: Ricardo Viebig [doi.org/10.1590/S0004-2803.24612026-043](doi.org/10.1590/S0004-2803.24612026-043) Vth Brazilian Consensus Conference on Helicobacter pylori infection Luiz Gonzaga Vaz COELHO1 , Bruno Squárcio Fernandes SANCHES1 , Ismael MAGUILNIK2 , James Ramalho MARINHO3 , Sandro Rodrigues CHAVES1,4 , Ana Flávia P. RAMOS5 , Heinrich SEIDLER6 , Ricardo C. BARBUTI7 , Renato S. LABOISSIÈRE1 , Laércio Tenório RIBEIRO8 , Maria do Carmo F. PASSOS5 , Julio César de Soares VELOSO9 , Lucia Libanês C. BRAGA10 , Frederico Passos MARINHO1 , Helenice P. BREYER2 , Hoiti OKAMOTO11 , Jardel Soares CAETANO12 , Paulo Pimentel D’ASSUMPÇÃO13 , Leonardo Soares da SILVA14 , Gerson DOMINGUES15 , Raul Carlos WAHLE16 , Eliza Maria de BRITO17 , Marcela Tavares da Rocha LOURES18 , Joaquim Prado MORAES-FILHO7 , Décio CHINZON7 , Áureo Almeida DELGADO19 1 Universidade Federal de Minas Gerais, MG, Brasil, 2 Universidade Federal do Rio Grande do Sul, RS, Brasil. 3 Universidade Estadual de Ciências da Saúde de Alagoas, AL, Brasil. 4 Rede Mater Dei de Saúde, MG, Brasil. 5 Santa Casa de Belo Horizonte, MG, Brasil. 6 Universidade Católica de Brasília, DF, Brasil. 7 Universidade de São Paulo, SP, Brasil. 8 Hospital Universitário Prof. Alberto Antunes, AL, Brasil. 9 Hospital Santa Helena, DF, Brasil. 10 Universidade Federal do Ceará, CE, Brasil. 11 Centro Médico Oxford, SC, Brasil. 12 Hospital Cárdio Pulmonar (Rede D’Or São Luiz), BA, Brasil. 13 Universidade Federal do Pará, PA, Brasil. 14 Hospital Adventista de Manaus, AM, Brasil. 15 Universidade do Estado do Rio de Janeiro, RJ, Brasil. 16 Universidade Federal de São Paulo, SP, Brasil. 17 Universidade Professor Edson Antônio Vellano, MG, Brasil. 18 Hospital Nossa Senhora das Graças, PR, Brasil. 19 Universidade Federal de Juiz de Fora, MG, Brasil. ABSTRACT – Background – Helicobacter pylori infection remains highly prevalent, affecting approximately 40% of the global population. Individuals with infection continue to be at risk for its various clinical consequences, including chronic gastritis, peptic ulcer disease, and gastric cancer. Objective – The Brazilian Helicobacter pylori and Microbiota Study Group and the Brazilian Federation of Gastroenterology present the Fifth Brazilian Consensus on this topic, following the inaugural edition in 1995. Significant advances ac

FAQs

What is the main purpose of the Fifth Brazilian Consensus on Helicobacter pylori infection?

To provide evidence-based recommendations that guide clinicians in managing Helicobacter pylori infection in the Brazilian population.

Who developed the consensus and what did the working groups produce?

Five working groups were established for epidemiology, associated diseases and treatment indications, diagnosis, gastric cancer, and treatment and microbiota, developing 34 evidence-based recommendations.

How does the consensus address antibiotic resistance in treatment planning?

It recommends 14-day treatments, emphasizing quadruple bismuth therapy and the use of P-CABs (such as vonoprazan) to maximize effectiveness as resistance increases.

Sep 23, 2026

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