H. pylori Management

[Mstahiki Mea]

✅ H. pylori Management:▶️ Indications for Testing→ Peptic ulcer disease (gastric or duodenal)→ Gastric MALT lymphoma→ Unexplained iron deficiency anemia→ Dyspepsia (age <60 with alarm symptoms or persistent)→ Family history of gastric cancer▶️ Diagnostic Tests→ Urea breath test (most accurate non-invasive)→ Stool antigen test→ Endoscopic biopsy with rapid urease test (gold standard if endoscopy done)→ Serology: NOT useful for confirming eradication▶️ First-Line Treatment (14 days)Bismuth Quadruple Therapy→ PPI (e.g., omeprazole)→ Bismuth subsalicylate→ Metronidazole→ TetracyclineORClarithromycin Triple Therapy (if no macrolide resistance)→ PPI→ Clarithromycin→ Amoxicillin (or metronidazole if penicillin allergy)▶️ Second-Line/Rescue Therapy→ Levofloxacin-based triple therapy→ Tailor regimen based on antibiotic resistance or previous exposure▶️ Confirm Eradication→ Urea breath test or stool antigen test ≥ 4 weeks after therapy, and ≥ 2 weeks off PPI→ Not serology (remains positive long-term)

 

[Numbisa]

Duh