Helicobacter Pylori Flashcards
What occurs in duodenal ulceration?
The duodenum becomes eroded as the mucosa is worn away by the acid secreted by the stomach.
How does helicobacter pylori survive in acidic pH?
It has high urease activity. This enables the bacteria to break down urea, which is found in the gastric juice, as well as in our blood, into ammonia and bicarbonate. The ammonium ion is a strong alkali. Therefore, the bacteria make a strong cloud of alkali by this enzyme between its inner and outer membrane. This allows the bacteria to grow in the acidic conditions of the stomach.
How does helicobacter pylori cause excess acid secretion?
The helicobacter pylori bacterium sits very near the G cells that are there to test the acidity of the environment. In normal acidic conditions G cells become switched off and gastric acid secretion from parietal cells becomes inhibited. H.Pylori raises the pH in the gland that means that G and D cells don’t see the real acidity of the stomach and thus they don’t turn off acid secretion.
What is triple therapy?
Triple therapy for H.Pylori includes 2 antibiotics and a proton pump inhibitor.
What is the first line treatment for H.Pylori?
- Omeprazole 40mg Mane
- Metronidazole 400mg TDS
- Amoxycillin 500mg TDS
What is the second line treatment for H.Pylori?
- Omeprazole 40mg Mane
- Clarithromycin 500mg TDS
- Amoxycillin 500mg TDS
What triple therapy is given if the patient is allergic to penicillin?
- Omeprazole 40mg Mane
- Metronidazole 400mg BD
- Clarithromycin 500mg BD
What is the relation of H.Pylori to the incidence of stomach cancer?
H.Pylori can cause inflammation, damaging the gastric mucosa and this was the main environmental factor in causing stomach cancer. It is a necessary, but not a sufficient factor for non-cardia gastric cancer. H.Pylori that causes a stomach ulcer and H.Pylori that caused stomach cancer are mutually exclusive.
What leads to gastric cancer?
- H.Pylori Infection
- Superficial Gastritis
- Atrophic Gastritis Hypochlorhydria
- Dysplasia and Cancer
How does oesophageal cancer occur?
Oesophageal cancer is caused by acid reflux into the oesophagus from the stomach, causing the squamous mucosa to change to columnar mucosa, this will then lead to Barratt’s oesophagus and eventually cancer.
