Helicobacter Pylori Infection

Question 1

What is H. pylori?

Answer 1

Slow growing spiral gram negative flagellate, urease producing bacterium which infects the gut and has a major role in gastritis and peptic ulcer disease

Question 2

Where is H. Pylori found?

Answer 2

Greatest numbers found under the mucous layer in gastric pits where it adheres specifically to gastric epithelial cells.

Question 3

How is H Pylori protected?

Answer 3

Protected from gastric acid by juxtamucosal mucous layer which traps bicarbonate secreted by antral cells and ammonia produced by bacterial urease

Question 4

How does H. Pylori spread?

Answer 4

Faecal- oral

Oral-oral

Question 5

Who gets H. Pylori?

Answer 5

V common in developing countries
More common in low socio-economic groups
Infection in childhood, presentation in adulthood

Question 6

How does H. Pylori present?

Answer 6

As gastritis

Question 7

How is gastritis diagnosed?

Answer 7

Gastric Biopsy
Urease Breath test 
(ensure patient hasn't taken PPIs/ABs)
-FAT(faecal antigen test)
-Serology (IgA- not accurate for older patients)

Question 8

How is H. Pylori treated?

Answer 8

Triple therapy for 1 week

• PPI & amoxicillin + clarithromycin
• PPI + metronidiazole + clarithromycin

Question 9

Side effects of treating H. Pylori?

Answer 9

Nausea

Diarrhoea

Question 10

Complications of H. Pylori?

Answer 10

Inflammation
Peptic ulcers
Gastric cancer