H. pylori and Gastric Disease

Question 1

H. pylori?

Answer 1

Gram negative spiral shaped

colonises on gastric type mucosa

evokes underlying immune response

Question 2

What is dyspepsia?

Answer 2

indigestion describing a group of symptoms

Question 3

ALARMS?

Answer 3

Anorexia
Loss of weight
Anaemia
Recent onset >55
Melaena/haematemesis or mass
Swallowing problems (dysphagia)

Question 4

What to do when px present with dyspepsia?

Answer 4

history + examination
Bloods (FBC, ferritin, Ca)
Drug history
Lifestyle

Question 5

Non-invasive diagnosis

Invasive

Answer 5

Serology IgG against H.pylori
Urea breath test
Stool antigen test

Endoscopy

Question 6

Peptic ulcer symptoms? (5)

Answer 6

epigastric and back pain
nausea and vomiting
weight loss
epigastric tenderness
bleeding symptoms (haematemesis/melaena)

Question 7

Treatment for peptic ulcers

Answer 7

H.pylori causing = eradication therapy
Antacid meds (H2antagonist/PPinhibitor)
Stop NSAIDs
Surgery only in complicated

Question 8

Eradication regime for H. pylori?

Answer 8

Triple therapy for 7 days
- clarithromycin
- amoxicillin
effective in 90% of cases