H.pylori and gastric disease Flashcards
Is H. pylori gram negative or gram +ve
-ve
What can H. Pylori cause
Asymptomatic or chronic gastritis (80%)
Intestinal metaplasia (15-20%)
gastric or duodenal ulcer (15-20%)
Gastric cancer (1%)
2 main types of H. Pylori infections
Antrum
body and fundus
H. Pylori in antrum leads to what
Increased Acid secretion
Increased chance of gastric and duodenal ulcers
Low risk of cancer
H. Pylori in body and fundus
Decreased acid secretion
Gastric Atrophy
High chance of cancer
Non invasive tests for H. Pylori
serum for IgG of H. pylori (cant tell if current)
Urea breath test
Stool antigen test
Invasive test for H. Pylori
First endoscope which collects cells
Histology (look for bacteria)
If bacteria then culture
Rapid urease test (CLO)
What is a rapid urease test
Biopsy used in test. If H. Pylori is present then test is positive. urease secreted by H. pylori converts molecules in test strip
How is gastritis diagnosed
Histology
Cant be done by endoscope
What else can cause or increase risk of gastric ulcers
smoking NSAID’s
Main symptom of peptic ulcer
epigastric pain
Symptoms of peptic ulcer
epigastric pain nocturnal/hunger pains back pain (posterior wall) nausea with occasional vomiting weight loss if ulcer is bleeding then anaemia/melaena/haematemesis
How is peptic ulcer treated
Eradicate H. Pylori
antacid- proton pump inhibitor or H2 receptor antagonist
If on NSAID try and reduce them
What is eradication therapy
7 day course of 3 different antibiotics
clarithromycin
amoxycillin
omeprazole
Complications of peptic ulcer
Bleeding-anaemia/melaena/haematemesis
perforation
fibrosis (stricture)
