Latinoamérica presenta una alta prevalencia de infección por Helicobacter pylori (Hp). Entre 1996-2003 la prevalencia en Santiago de Chile fue del 70%; estudios recientes presentan una disminución en esta infección. Actualizar la frecuencia de Hp es fundamental debido a su impacto en la salud asociado. Objetivo: Nuestro objetivo fue describir la tendencia de la infección por Hp en pacientes que asisten a endoscopía digestiva alta (EDA) ambulatoria en una población chilena. Materiales y métodos: Se realizó un estudio observacional retrospectivo de pacientes mayores de 18 años que asistieron a una primera EDA con test rápido de ureasa entre 2010-2020. La tendencia en el tiempo fue descrita mediante análisis de series de tiempo. Se construyó un modelo Poisson para estimar el riesgo de infección, ajustado por edad y sexo. Resultados: Se incluyeron 11 355 pacientes [66,9% mujeres; edad media 52 años; Hp 41,6%]. El sexo masculino presentó una mayor frecuencia de infección por Hp [RR 1,13; (IC95%:1,08-1,18)]. La frecuencia de Hp disminuyó significativamente desde 45,1% en 2010 hasta 29% en 2020, con 36% menor probabilidad de presentar infección por Hp en 2020 con respecto al 2010 [RR 0,64; (IC95%:0,55-0,74)]. Se proyectó un descenso progresivo en la tendencia de infección por Hp hasta valores cercanos al 25% para el año 2025. Conclusión: Se observó una reducción significativa en la infección por Hp entre los años 2010-2020. Esta disminución pudiese ser explicada mediante la incorporación de políticas públicas de salud en la última década asociadas a cambios sociosanitarios.

Drug-induced esophageal ulcers constitute an acquired chemical injury to the esophageal mucosa, most frequently associated with tetracyclines, particularly doxycycline. We report a case of "kissing ulcers" diagnosed through esophagogastroduodenoscopy in a young woman undergoing doxycycline treatment for rosacea. The pathogenesis is linked to drug-specific factors, such as caustic effects, hyperosmolar properties, and prolonged mucosal contact with the medication, in addition to patient-specific risks, including esophageal motility disorders, reduced saliva production, and mid-esophageal anatomical compression. Clinically, patients commonly present with abrupt-onset chest pain, dysphagia, and odynophagia, while endoscopic findings often reveal mucosal erythema, erosions, and specular distribution esophageal ulcers (referred to as “kissing ulcers”). Management involves discontinuation of the causative drug, initiation of proton pump inhibitors or sucralfate, and implementation of preventive measures, such as ensuring adequate hydration during medication intake. This condition is generally self-limiting, with symptoms resolving within two weeks, underscoring the importance of prompt diagnosis and treatment to avoid potential complications.

Gastric cancer (GC), a significant cause of mortality globally, is the leading cause of cancer-related deaths among Latin American men. GC is usually diagnosed at an advanced stage; therefore, therapeutic options are limited, and prognosis is poor. Helicobacter pylori infection remains the primary risk factor for GC; therefore, primary prevention directed toward diagnosis and treatment (“test-and-treat” strategy) is important. Western medicine guidelines recommend esophagogastroduodenoscopy (EGD) for at-risk individuals aged >40 years with regular surveillance in patients with gastric premalignant conditions (GPMC). However, limited availability of EGD in Latin America necessitates development of risk stratification tools to minimize the endoscopic burden. Results from the Chilean “Endoscopic Cohort and Histological Operative Link on Gastric Assessment (OLGA) Staging” (ECHOS study), propose endoscopic surveillance of advanced GPMC (OLGA/Operative Link for Gastric Intestinal Metaplasia [OLGIM] stages III–IV) with reliable risk stratification to facilitate early GC detection. Ensuring high-quality EGD and enhanced diagnostic yield of GPMC is essential. GPMC grading tools, such as the Kimura-Takemoto or Endoscopic Grading of Gastric Intestinal Metaplasia classification, should be incorporated into the regular risk assessment protocol. However, obtaining mapping gastric biopsies using standardized methods such as the updated Sydney System biopsy protocol, followed by grading of chronic atrophic gastritis with or without intestinal metaplasia using the OLGA and OLGIM staging systems are preferred for GC risk stratification. Recent GC prevention strategies recommended in Chile include a “test-and-treat” approach for H. pylori in individuals aged 35–44 years and combined H. pylori/pepsinogen I–II serology and EGD evaluation in patients aged >45 years to optimize the limited preventive resources available in the region.

Gastric cancer is one of the leading causes of cancer mortality in Chile. To optimize early detection and surveillance of gastric premalignant conditions, the Chilean Association of Digestive Endoscopy (ACHED), together with the Chilean Society of Gastroenterology, updated its 2014 clinical guideline. Using the AGREE II methodology, multidisciplinary working groups conducted systematic reviews in PubMed, Cochrane, and Scielo through December 2024. Recommendations were agreed upon via a Delphi panel (≥ 80 % agreement) and graded according to GRADE, assessing evidence quality and recommendation strength. An expert panel of Chilean and international gastroenterology, endoscopy and pathology specialists reviewed the evidence and reached consensus to issue recommendations for opportunistic gastric cancer screening and surveillance using upper GI endoscopy in adults. These recommendations are feasible to implement in Chile and other Latin American countries with a high incidence of gastric cancer that have the necessary resources available. They complement any future efforts at population screening and aim to improve early detection and prognosis of gastric cancer in high-risk populations.