MODERN APPROACHES TO THE DIAGNOSIS AND THERAPY OF HELICOBACTER PYLORI: ANALYSIS OF AWARENESS AND PERCEPTION BARRIERS

Introduction. In the Republic of Kazakhstan, the problem of Helicobacter pylori (H. pylori) is of particular importance due to the high incidence of gastrointestinal diseases and limited access to modern diagnostic and therapeutic methods in some regions. Despite the availability of international clinical guidelines, implementing these approaches in clinical practice requires not only technical and organizational support but also a high level of awareness and commitment from primary care and specialized physicians.

The purpose of the study. To assess the level of awareness among physicians in the Republic of Kazakhstan regarding current approaches to the diagnosis and treatment of H. pylori infection, as well as to the symptomatic management of dyspeptic disorders, and to identify key barriers that hinder the prevention and treatment of this infection.

Materials and Methods. This descriptive observational study involved interviewing 175 general practitioners (GPs) and 35 gastroenterologists from 6 regions of Kazakhstan.

Results. The study showed that gastroenterologists generally have a higher level of awareness of modern approaches to the diagnosis and treatment of H. Pylori compared to GPs. Recommendations of clinical protocols remain the most important criterion for both gastroenterologists and GPs when choosing a treatment regimen for H. pylori infection. The primary reasons for the failure of eradication therapy, according to both groups of specialists, are bacterial resistance to antibiotics, insufficient patient awareness of the risks associated with H. pylori persistence, and the importance of completing treatment.

Conclusions. Gastroenterologists have a higher level of awareness than GPs; they also more often use modern diagnostic methods and focus on local antibiotic resistance when choosing treatment regimens. Primary care physicians remain a key link in patient routing; however, their needs for additional training and support are more pronounced.

1. Bhandari A., Crowe S.E. Helicobacter pylori in Gastric Malignancies // Curr Gastroenterol Rep. 2012. Vol. 14, № 6. P. 489–496.

2. Wroblewski L.E., Peek R.M., Wilson K.T. Helicobacter pylori and Gastric Cancer: Factors That Modulate Disease Risk // Clin Microbiol Rev. 2010. Vol. 23, № 4. P. 713–739.

3. Malfertheiner P. et al. Helicobacter pylori infection // Nat Rev Dis Primers. 2023. Vol. 9, № 1. P. 19.

4. Salih B.A. Helicobacter pylori Infection in Developing Countries: The Burden for How Long? // Saudi J Gastroenterol. 2009. Vol. 15, № 3. P. 201–207.

5. Aldhaleei W.A. et al. Helicobacter pylori: A concise review of the latest treatments against an old foe // CCJM. Cleveland Clinic Journal of Medicine, 2024. Vol. 91, № 8. P. 481–487.

6. Jeradikacija Helicobacter pylori-infekcii v Kazahstane (A.S. Bazhikova) [Electronic resource] // Informacionnaja sistema PARAGRAF. URL:https://online.zakon.kz/Document/?doc_id=30489425 (accessed: 06.07.2025).

7. Jaroń K. et al. Diagnostic and therapeutic recommendations on Helicobacter pylori infection. Recommendations of the Working Group of the Polish Society of Gastroenterology // Prz Gastroenterol. 2023. Vol. 18, № 3. P. 225–248.

8. Sun M. et al. A scoping review of worldwide guidelines for diagnosis and treatment of Helicobacter pylori infection // Syst Rev. 2025. Vol. 14. P. 107.

9. Boltin D., Dotan I., Birkenfeld S. Improvement in the implementation of Helicobacter pylori management guidelines among primary care physicians following a targeted educational intervention // Ann Gastroenterol. 2019. Vol. 32, № 1. P. 52–59.

10. Pourhoseingholi M.A., Vahedi M., Rahimzadeh M. Sample size calculation in medical studies // Gastroenterol Hepatol Bed Bench. 2013. Vol. 6, № 1. P. 14–17.

11. Maqbul M.S. et al. Prevalence of knowledge and awareness about Helicobacter pylori infection among urban population of Kingdom of Saudi Arabia // Gastroenterology & Endoscopy. 2024. Vol. 2, № 4. P. 196–204.

12. Na’amnih W. et al. Physicians’ adherence to management guidelines for H. pylori infection and gastroesophageal reflux disease: a cross-sectional study // Israel Journal of Health Policy Research. 2020. Vol. 9, № 1. P. 28.

13. O’Connor A., Gisbert J., O’Morain C. Treatment of Helicobacter pylori infection // Helicobacter. 2009. Vol. 14 Suppl 1. P. 46–51.

14. Graham D.Y., Shiotani A. New concepts of resistance in the treatment of Helicobacter pylori infections // Nat Clin Pract Gastroenterol Hepatol. 2008. Vol. 5, № 6. P. 321–331.

15. Camilleri M. et al. Clinical guideline: management of gastroparesis // Am J Gastroenterol. 2013. Vol. 108, № 1. P. 18–37; quiz 38.

16. Tack J., Camilleri M. New developments in the treatment of gastroparesis and functional dyspepsia // Curr Opin Pharmacol. 2018. Vol. 43. P. 111–117.

17. Wasko-Czopnik D., Wiatrak B. The efficacy and safety of itopride as an add-on therapy to a proton pump inhibitor in the treatment of gastroesophageal reflux disease // Prz Gastroenterol. 2024. Vol. 19, № 1. P. 60–66.

18. Lefebvre M. et al. Adherence and barriers to H. pylori treatment in Arctic Canada // Int J Circumpolar Health. 2013. Vol. 72. P. 10.3402/ijch.v72i0.22791.

19. Huguet J.M. et al. Role of compliance in Helicobacter pylori eradication treatment: Results of the European Registry on H. pylori management // United European Gastroenterol J. 2024. Vol. 12, № 6. P. 691–704.

20. Shakya Shrestha S. et al. Medication Adherence Pattern and Factors affecting Adherence in Helicobacter Pylori Eradication Therapy // Kathmandu Univ Med J (KUMJ). 2016. Vol. 14, № 53. P. 58–64.