Fast Five Quiz: Review Key Aspects of Peptic Ulcer Disease

Jamie Shalkow, MD

Disclosures

May 11, 2017

The 2017 American College of Gastroenterology (ACG) guideline for the treatment of H pylori infection includes the following recommendations for testing:

  • All patients with active or history of PUD (unless previous cure of H pylori infection has been documented), low-grade gastric mucosa-associated lymphoid tissue lymphoma, or a history of endoscopic resection of early gastric cancer

  • Patients with dyspepsia who are undergoing upper endoscopy (gastric biopsy specimens)

  • Patients on long-term, low-dose aspirin

  • Patients initiating long-term therapy with NSAIDs

  • Patients with unexplained iron deficiency anemia following standard workup

  • Adults with idiopathic thrombocytopenic purpura

Obtain histopathology, often considered the criterion standard to establish a diagnosis of H pylori infection, if the rapid urease test result is negative and a high suspicion for H pylori persists (presence of a duodenal ulcer).

Antibodies (immunoglobulin G) to H pylori can be measured in serum, plasma, or whole blood. Results with whole blood tests obtained from finger sticks are less reliable.

Fecal antigen testing identifies active H pylori infection by detecting the presence of H pylori antigens in stools. This test is more accurate than antibody testing and is less expensive than urea breath tests.

For more on the workup of PUD, read here.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....