Stomach Disorders: H. pylori and Gastric Cancer

Question 1

What is Helicobacter Pylori?

Answer 1

• A type of bacteria that infects your stomach.
• It can damage the tissue in your stomach and the duodenum.
• This can cause redness and soreness (inflammation).
• It is the main cause of peptic ulcers

Question 2

What are the isolation precautions for H. pylori?

Answer 2

• Contact

Question 3

How is H. pylori spread?

Answer 3

• May be passed from person to person through direct contact with saliva, vomit or fecal matter
• May also be spread through contaminated food or water
• Poorly developed countries have higher rates of transmission

Question 4

The infection rate of H. pylori is twice that than Covid. Why doesn’t it get as much attention?

Answer 4

• Deaths contributed to H. pylori are rare

Question 5

What kinds of food feed the growth of H. pylori?

Answer 5

• Sweets
• Fatty meats
• Fried food

Question 6

What are the s/s of a possible H. pylori infection?

Answer 6

• Same as gastric ulcers with the addition of:
o Pain is often worse on an empty stomach
o Night time pain is common
o Belching

Question 7

True or False

An H. pylori infection is always symptomatic.

Answer 7

• False, it can be asymptomatic

Question 8

What is the basic treatment for H. pylori?

Answer 8

• PPI w/ abx

Question 9

What is triple therapy for H. pylori?

Answer 9

• PPI + 2x Abx (amoxicillin, clarithromycin)

Question 10

What is Bismuth Quadruple Therapy for H. pylori?

Answer 10

• PPI + 3x Abx (Bismuth compound, metronidazole, tetracycline)

Question 11

What is Non-Bismuth Quadruple Therapy for H. pylori?

Answer 11

• PPI + 3x Abx (Amoxacillin, clarithromycin, metronidazole)

Question 12

How long does the therapy for H. pylori last?

Answer 12

• About 2 wks

* Pt will return for stool test for H. pylori

Question 13

The HCP may decide to do a combination therapy. What are the 3 and how many tabs would be taken for each?

Answer 13

• Helidac/2 tabs (1xPPI, 1xAbx)
• Prevpac/1 tab (tab contains both PPI and Abx)
• Pylera/2 tabs (1xPPI, 1xAbx)

Question 14

ost cancers of the stomach are of what type and start where?

Answer 14

• Adenocarcinomas

* Developed in the mucosal cells

Question 15

What conditions increase risk of gastric cancer?

Answer 15

• H. Pylori infection
• Pernicious anemia
• Gastric polyps
• Chronic atrophic gastritis
• Achlorhydria (absence of secretion of Hcl)
• High Na foods
• Barrett’s esophagus
• GERD

Question 16

What are the race/age factors for gastric cancer?

Answer 16

• Average age = 70

* Incidence is high amongst Asians

Question 17

True or False

Early s/s of gastric cancer are 80% asymptomatic and 10% have peptic ulcer symptoms.

Answer 17

• True

Question 18

Order the following for s/s of advanced gastric cancer from highest to lowest percentages.
Anorexia, abdominal pain, weightloss, N/V

Answer 18

• Weight loss: 60%
• Abdominal pain: 50%
• N/V and Anorexia: 30%

Question 19

What are the two monoclonal antibodies for gastric cancer?

Answer 19

• Cyramza (ramucirumab)

* Herceptin (trastuzumab)

Question 20

How does Cyramza (ramucirumab work)

Answer 20

• Ramucirumab is a monoclonal antibody that binds to a VEGF receptor. T
• his keeps VEGF from binding to cells and telling them to make more blood vessels. This can help slow or stop the growth of some cancers

Question 21

How does Herceptin (transtuzumab) work?

Answer 21

• Herceptin (trastuzumab) used to block HER2 receptors preventing/slowing cancer growth