H. Pylori

Question 1

what

Answer 1

gram negative bacterium

buries into gastric epithelium and releases urease which damages epithelium

Question 2

testing at endoscopy

Answer 2

rapid urease test

Question 3

guidance for patients pre-endoscopy

Answer 3

do not take antibx or bismuth products for 4wks before

no PPI 2wks before

Question 4

Mx

Answer 4

amoxicillin, clarithromycin and PPI BD for 7 days

if penicillin allergic - metronidazole can replace amoxicillin

re-test for h.pylori 4-8wks

Question 5

Mx - still present at re-test 4-8ws

Answer 5

another course of triple therapy with metronidazole or clarithromycin (whichever not used first time) , amoxicillin + PPI