Helicobacter pylori infection history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Specific areas of focus when obtaining a history from the patient include history of nausea, vomiting, epigastric pain or abdominal pain, bloating, gastrointestinal bleeding, anorexia, weight loss, pallor, a positive history of GI diseases or H. pylori infection, history of medication use (NSAIDS) and food and drinking water hygiene. Majority of patients infected are asymptomatic. Symptoms of H. pylori infection include halitosis, nausea, vomiting, epigastric or abdominal pain, bloating, belching, dark or tarry like stools (melena), fatigue, diarrhea and unexplained weight loss.
History
Specific areas of focus when obtaining a history from the patient include history of:[1][2][3]
- Nausea & vomiting
- Epigastric or abdominal pain
- Bloating
- Pain aggravating or relieving with food
- Gastrointestinal bleeding
- Anorexia
- Weight loss
- Pallor
- Previous laboratory findings of anemia
- A positive family history of GI diseases or H. pylori infection
- History of medication use (NSAIDS)
- Food and drinking water hygiene
If H. pylori infection is suspected in children, the history of the patient should include:
- Pain (location, character, duration, radiation, severity, aggravating and relieving factor)
- Diet, appetite and weight changes
- Nausea
- Vomiting
- Bloating
- A positive family history of Gastrointestinal diseases (eg., Ulcers, crohn's disease) or H. pylori infection
- History of NSAIDS use
- Food and drinking water hygiene
Symptoms
Majority of patients infected are asymptomatic. Symptoms of H. pylori infection include:
- Halitosis
- Nausea
- Vomiting
- Epigastric or abdominal pain
- Bloating
- Belching
- Early satiety
- Dark or tarry like stools (melena)
- Fatigue
- Diarrhea
- Unexplained weight loss
Functional dyspepsia
Functional dyspepsia: Rome III diagnostic criteria for gastrointestinal disorders
B1. FUNCTIONAL DYSPEPSIA
Diagnostic criteria Must include:[4]
1: One or more of the following:
- Bothersome postprandial fullness
- Early satiety
- Epigastric pain
- Epigastric burning
And
2: No evidence of structural disease (including at upper endoscopy) that is likely to explain the symptoms
- Criteria fulfilled for the last 3 months with symptom onset
at least 6 months prior to diagnosis
Dyspepsia Approach
Approach to the management of dyspeptic patients
| Dyspeptic patient First primary care visit | |||||||||||||||||||
| <45 years* without alarm symptoms | >45 years or with alarm symptoms irrespective of age | ||||||||||||||||||
| Review patient's history Test for Helicobacter pylori 13C UBT or Laboratory serology | Refer to gastroenterologist | ||||||||||||||||||
| If H.pylori positive, treat the infection | |||||||||||||||||||
Adopted from Gut 1997 Jul; 41(1): 8–13.[5]
- The cutoff value may be below 45 years of age depending on regional differences in the incidence of gastric malignancy
References
- ↑ Kusters JG, van Vliet AH, Kuipers EJ (2006). "Pathogenesis of Helicobacter pylori infection". Clin Microbiol Rev. 19 (3): 449–90. doi:10.1128/CMR.00054-05. PMC 1539101. PMID 16847081.
- ↑ Testerman TL, Morris J (2014). "Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment". World J Gastroenterol. 20 (36): 12781–808. doi:10.3748/wjg.v20.i36.12781. PMC 4177463. PMID 25278678.
- ↑ Garza-González E, Perez-Perez GI, Maldonado-Garza HJ, Bosques-Padilla FJ (2014). "A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication". World J Gastroenterol. 20 (6): 1438–49. doi:10.3748/wjg.v20.i6.1438. PMC 3925853. PMID 24587620.
- ↑ Rome III diagnostic criteria http://www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf Accessed on January 9, 2017
- ↑ "Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. European Helicobacter Pylori Study Group". Gut. 41 (1): 8–13. 1997. PMC 1027220. PMID 9274464.