H Pylori and Gastric Disease Flashcards
Is helicobacter pylori gram - or +?
Gram negative
Which type of tissue is the only tissue that H.pylori can colonise?
Gastric mucosa
Which enzyme can Hi.pylori produce?
Urease
What does urease allow the bacteria to do?
Creates an acidic microclimate so it can penetrate through the mucus layer and attach itself to the stomach epithelium
What % of the population is affected by H.pylori?
50%
What are some of the clinical outcomes of having a H.pylori infection?
Majority remain asymptomatic
Gastritis
Gastric ulcer
Gastric cancer
If the H.pylori affects the antrum of the stomach with gastritis, what could this develop into?
Duodenal ulcer disease
Does gastritis affecting the antrum lead to increased or decrease in acid production?
Increase
Does gastritis affecting the body lead to increased or decrease in acid production?
Decrease
If the H.pylori affects the body of the stomach with gastritis, what could this develop into?
Gastric cancer
How do you diagnose a H.pylori infection non-invasively?
Serology for immunoglobulins
Urea breath test C13/C14
Stool antigen test
How do you diagnose a H.pylori infection invasively?
Gastric biopsies for histology
Culture of gastric biopsies
Rapid slide urease test (CLO)
Which colour does the CLO test turn to indicate H.pylori is present?
Pink
What is gastritis?
Inflammation of the gastric mucosa
What are the three subdivions of gastritis?
Autoimmune
Bacterial
Chemical
ABC
Which are more common- gastric ulcers or duodenal ulcers?
Duodenal ulcers
What are the majority of peptic ulcers caused by?
H.pylori infection
What other things can cause peptic ulcers?
Smoking
NSAIDs
Which symptoms are associated with a peptic ulcer?
Epigastric pain
Back pain
Nausea, occasionally vomiting
Weight loss, anorexia
Epigastric tenderness
Which symptoms may present if the ulcer is bleeding?
Haematemesis
Anaemia
Which drugs help to reduce the acid and help treat peptic ulcers?
Proton pump inhibitors
Which drug should be stopped if a patient has a peptic ulcer?
NSAIDs
Which three drugs are part of the eradication therapy for H.pylori?
Clarithromycin
Amoxicillin
Proton Pump Inhibitor e.g. omeprazole
What is the main reason that triple eradication therapy would not eradicate H.pylori?
Resistance to antibiotics
Or lack of compliance to medication
What are the complications of peptic ulcer disease?
Bleeding- acute or chronic
Perforation
Fibrotic stricture (narrowing)
Gastric outlet obstruction
What can happen as a result of acute bleeding of a peptic ulcer?
Melaena (black poo)
Haematemesis
What can happen as a result of chronic bleeding of a peptic ulcer?
Iron deficiency anaemia
How do people present with gastric outlet obstruction?
Vomiting but vomit lacks bile and is of fermented foodstuffs
Why do people with gastric outlet obstruction have dehydration?
All the vomiting
How can gastric outlet obstruction be treated?
Endoscopic balloon dilation surgery
Are the majority of gastric cancers adenocarcinomas or squamous cell carciomas?
Adenocarcinomas
