Helicobacter pylori

Revision as of 07:29, 19 July 2016 by Neil.m.young (talk | contribs) (Text replacement - "0 mg" to "0mg")

Background

  • H. pylori is a gram negative bacteria that causes gastritis, peptic ulcer disease, and gastric adenocarcinoma.

Clinical Features

Differential Diagnosis

Epigastric Pain

Diagnosis

  • Non-invasive Testing
    • Urea Breath Testing
    • Serology - ELISA
    • Stool Antigen Assay
  • Invasive Testing - Endoscopy

Management

  • Though feasible in the ED[1], antibiotic therapy is typically not offered
  • Beware of other causes of abdominal pain despite positive testing

Triple Therapy

  • PPI plus clarithromycin 500mg twice daily, and amoxicillin 1000mg twice daily for 10-14 days
  • If PCN allergic: PPI plus clarithromycin 500mg twice daily, metronidazole 500mg twice daily for 10-14 days

Disposition

  • Discharge with GI outpatient follow-up

See Also

External Links

References

  1. Meltzer AC, et al. Rapid (13) C urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain. WJ Emerg Med. 2013; 14:278-282.