H.Pylori

Question 1

What is the structure of H.pylori ?

Answer 1

• Gram -ve
• Motile (Flagella)

Question 2

How does H.pylori cause damage ?

Answer 2

• Urease (Enzyme) positive –Urease can hydrolyse urea to produce ammonia and carbon dioxide. Neutralises gastric acidity by increasing PH and allowing it to survive harsh acidic stomach conditions.
• This can cause Parietal cells to produce more HCL in response.
• Some Pylori release CagA (cytotoxin-associated gene A), which causes inflammation and breaks down epithelial cells, causing ulcers that can lead to perforation.

Question 3

What are the symptoms of H.pylori ?

Answer 3

• Most people have NO symptoms.
• Symptoms are related to stomach inflammation and ulcers.
• Nausea and vomiting
• Upper abdominal pain/ discomfort
• Frequent burping

Severe symptoms
- Vomiting blood or recurrent vomiting
- Black tarry or blood stool
- Anaemia
- Family history of GI Cancer.

Question 4

How to diagnose H.pylori ?

Answer 4

Diagnosis
- Stool antigen
- Urea breath test (UBT)
- Rapid Urea Test (RUT) – Biopsy
- Endoscopy

Question 5

What is the treatment for h.pylori?

Answer 5

• PPI initially +2 x ABX therapy when confirmed.