Ver el código de «Helicobacter pylori»

==Background==
*''H. pylori'' is a gram negative bacteria that causes [[gastritis]], [[peptic ulcer disease]], and gastric adenocarcinoma.

==Clinical Features==
*[[Epigastric abdominal pain]]
*[[Gastroesophageal Reflux Disease]]

==Differential Diagnosis==
{{Abdominal Pain DDX Epigastric}}

==Evaluation==
*Non-invasive Testing
**Urea Breath Testing
**Serology - ELISA
**Stool Antigen Assay
*Invasive Testing - Endoscopy

==Management==
*Though feasible in the ED<ref>Meltzer AC, et al. Rapid (13) C urea breath test to identify Helicobacter pylori infection in emergency department patients with upper abdominal pain. WJ Emerg Med. 2013; 14:278-282.</ref>, antibiotic therapy is typically not offered
*Beware of other causes of abdominal pain despite positive testing
===Triple Therapy===
*[[PPI]] plus [[clarithromycin]] 500mg twice daily, and [[amoxicillin]] 1000mg twice daily for 10-14 days
*If penicillin allergic: PPI plus [[clarithromycin]] 500mg twice daily, [[metronidazole]] 500mg twice daily for 10-14 days
*Concomitant therapy adds [[metronidazole]] 500 mg BID to triple therapy for 10-14 days
===[[Bismuth subsalicylate|Bismuth]] Quadruple Therapy===
*May have highest eradication rates as compared to classical triple therapy or concomitant therapy<ref>Liou JM et al. Concomitant, bismuth quadruple, and 14-day triple therapy in the first-line treatment of Helicobacter pylori: a multicentre, open-label, randomised trial. Lancet 2016. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)31409-X/fulltext?rss=yes.</ref>
*Bismuth quadruple therapy for 10 days:
**[[Bismuth subsalicylate]] 300 mg QID
**[[Lansoprazole]] 30 mg BID
**[[Tetracycline]] 500 mg QID
**[[Metronidazole]] 500 mg TID

==Disposition==
*Discharge with GI outpatient follow-up

==See Also==
*[[Peptic Ulcer Disease]]
*[[Gastroesophageal Reflux Disease]]

==External Links==

==References==
<references/>

[[Category:GI]]
[[Category:ID]]