H. Pylori Flashcards
What is the aim for treating duodenal ulcers
To reduce acid secretion
What are the treatment options available presently to treat duodenal ulcers
• H2 blockers
• Proton pump inhibitors
–> acid lowering drugs
• Two drugs – bismuth salt and sucralfate, healed ulcers without lowering acid
Describe H. Pyloris prevalence in the developed and developing world
Developing world:
related to living conditions of a person when they were young, person gets infected when they are young and carries it to the rest of their life
Developed world:
relates to a person’s socio-economic status
(H. Pylori is more prevalent as age increases)
What is the pathogenesis of duodenal ulcer
• H. Pylori infection OR other risk factors e.g. smoking, NSAIDs
- Disturbance in gastrin/somatostatin regulation
- Excess acid secretion
This leads to Gastric Metaplasia -> H.Pylori Colonisation -> Ulceration = duodenal ulcer
What is the treatment for duodenal ulcers
PPIs and 2 antibiotics
Give example of 1st line treatment for duodenal ulcer
- Omeprazole 40mg (PPI)
- Metronidazole 400mg
- Amoxycillin 500mg
Give example of 2nd line treatment for duodenal ulcer
- Omeprazole 40mg (PPI)
- Clarithromycin 500mg
- Amoxycillin 500mg
Give example of treatment for duodenal ulcer if patient is allergic to penicillin
- Omeprazole 40mg (PPI)
- Metronidazole 400mg
- Clarithromycin 500mg
What is the relation between H. Pylori and gastric cancer
H. pylori is related to the pathogenesis of developing gastric cancer
> 95% attributable to H.pylori
What is the genetic predisposition in some people with stomach cancer but no traces of H. Pylori
Autosomal dominant
E-Cadherin germline mutation
Whats the relationship between H. pylori and peptic ulcer and devloping gastric cancer
Those with H. pylori and a peptic ulcer are less likely to develop gastric cancer as compared to individuals who just have H. pylori but no peptic ulcer.
What happens if H. Pylori causes DECREASED acid in the stomach (describe pathogenesis)
Leads to Gastric cancer
H. Pylori infection -> superficial gastritis -> atrophic gastritis (inflammation destroyed cells of the stomach- cells not working properly and do not secrete acid) -> dysplasia and cancer
is there atrophy in duodenal ulcer?
NO
H. Pylori –> No atrophy (increased acid) -> duodenal ulcer
What are the factors that increase the development of gastric cancer
• Host genetics
• Bacterial strain
–> Above two factors promote the development of superficial gastritis
• Male gender- promotes development of dysplasia and cancer
• Smoking and Diet- promotes development of superficial gastritis and cancer
What is the parietal and chief cell densities in Positive H. pylori individuals
increased
