HELICOBACTER PYLORI AND PEPTIC ULCER

 

 

 

Microbiology

Formerly Campylobacter pylori
Spiral-shaped gram-negative bacillus
Ability to survive the acidic pH of gastric fluids

Epidemiology

Implicated as a cause of duodenal and gastric ulcers
Infection increasing with age
Natural reservoir in humans
Transmission is fecal-oral

Clinical syndromes

Duodenal and gastric ulcers
Dyspepsia (non-ulcer)
Gastric carcinoma

Diagnosis

Urease test (breath test)
Culture
Gastric biopsy
Serology

Comments on treatment

Susceptible in vitro to a variety of antimicrobial agents: Tetracycline, Metronidazole, Amoxicillin and Clarithromycin
Resistance to these antibiotics has been described (associated with treatment failures)
Recommended: see Ulcer, Gastric & Duodenal for more details
Amoxicillin and Clarithromycin and (omeprazole or lansoprazole)
Alternative: 
bismuth and Tetracycline and Metronidazole and omeprazole