Helicobacter Pylori Flashcards
How to classify?
Gram negative short spiral with external flagella
How is it transmitted?
Oral-oral and/or faecal oral
What is the source?
Human
Which body part does it infect?
Gastric-type epithelium
-Urease neutralises stomach acid
What condition is common?
Dyspepsia
What diseases does it lead to?
- Peptic ulceration (duodenal, gastric)
- Gastric cancer
- Gastric MALT lymphoma
What tests can be done?
Non-invasive if lower risk of gastric cancer
Invasive: endoscopy if higher risk
Take biopsies to check for cancerous lesions
What non-invasive diagnosis?
Stool antigen test, urea breath test (13C or 14C labelled urea), serology (cannot test for cure)
Why might stool antigen and urea breath test be false negative?
Antibiotics, PPI, acute bleed
- stop the drugs and test a few weeks later
What invasive diagnosis test?
Gastroscopy/biopsy to see tumours
Microscopy/histopathology
Rapid urease test (can be positive within an hour)
Culture and susceptibility
What is the treatment?
Empiric first line therapies (2 weeks)
1. Clarithromycin containing triple therapy (+ omeprazole + amoxicillin)
2. Bismuth quadruple therapy
AMR is a problem so biopsy is desirable
