helicobacter%20pylori%20infection
HELICOBACTER PYLORI INFECTION
Treatment Guideline Chart
Helicobacter pylori is a spiral-shaped Gram-negative bacterium involved in the development of gastritis, duodenal and gastric ulcers, and gastric cancer.
Infection is strongly associated with the development of gastric epithelial and lymphoid malignancies.
Acute infection is mostly asymptomatic and is acquired through human-to-human contact via gastro-oral and fecal-oral routes.
Adaptability in gastric conditions and production of urease allow it to colonize the stomach.

Helicobacter%20pylori%20infection Management

Follow Up

Patient should be re-tested after a minimum of 4 weeks after treatment

  • It is advisable to confirm eradication of H pylori with a post-treatment UBT, monoclonal stool test or upper endoscopy with biopsy
    • Antisecretory drugs especially PPIs should be discontinued at least 1-2 weeks prior to post-test, while Bismuth compounds and antibiotics should be stopped at least 4 weeks prior to test 
  • Patients with either gastric ulcers or complicated duodenal ulcers should have a repeat endoscopy and biopsy, UBT, or stool antigen test to rule out malignancy
  • In patients with persistent H pylori infection, a culture and sensitivity may be done before retreatment, except when considering a Bismuth-based quadruple therapy
  • Serology is not used in determining treatment response
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