Helicobacter pylori
| with thanks to Barry Marshall... | |
|---|---|
| Etiology | spiral-shaped, Gram negative bacterium associated with chronic gastritis. Linked to gastric MALTomas (as in, eradication causes regression!) |
| Epidemiology | |
| Clinical presentation | peptic ulcer disease |
| Pathogenesis | Virulence factors: 1. flagella - motile in mucus 2. urease 3. adhesins 4. toxins e.g. CagA - associated with cancer, possibly |
| Diagnostic investigations | - Urease breath test or stool/serum antigen test → patient must be off PPI for at least 2/52, and/or 4/52 off abx - Biopsy |
| Management | Eradication: proton pump inhibitor + amoxicillin + clarithromycin, or a proton pump inhibitor + metronidazole + clarithromycin |