Peptic ulcer laboratory tests: Difference between revisions
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**Positive for Helicobacter pylori infection. | **Positive for Helicobacter pylori infection. | ||
**Drug NSAID-induced. | **Drug NSAID-induced. | ||
** | **''Helicobacter pylori'' and NSAIDs positive. | ||
**H pylori and NSAIDs negative (requires search for other causes). | **''H. pylori'' and NSAIDs negative (requires search for other causes). | ||
*Approach of patients <55 years, depending of the | *Approach of patients <55 years, depending of the ''H. pylori'' (''H. pylori'') prevalence (≥10%):<ref name="pmid16181387">{{cite journal| author=Talley NJ, Vakil N, Practice Parameters Committee of the American College of Gastroenterology| title=Guidelines for the management of dyspepsia. | journal=Am J Gastroenterol | year= 2005 | volume= 100 | issue= 10 | pages= 2324-37 | pmid=16181387 | doi=10.1111/j.1572-0241.2005.00225.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16181387 }} </ref> | ||
**Test and treat for H. pylori using a validated noninvasive test and a trial of acid suppression if eradication is successful but symptoms do not resolve '''OR''' | **Test and treat for ''H. pylori'' using a validated noninvasive test and a trial of acid suppression if eradication is successful but symptoms do not resolve '''OR''' | ||
**Empiric trial of acid suppression with a proton pump inhibitor (PPI) for 4-8 weeks. | **Empiric trial of acid suppression with a proton pump inhibitor (PPI) for 4-8 weeks. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
Revision as of 19:36, 3 June 2014
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Peptic ulcer Microchapters |
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Diagnosis |
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Treatment |
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Surgery |
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Case Studies |
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2017 ACG Guidelines for Peptic Ulcer Disease |
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Guidelines for the Indications to Test for, and to Treat, H. pylori Infection |
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Guidlines for factors that predict the successful eradication when treating H. pylori infection |
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Guidelines to document H. pylori antimicrobial resistance in the North America |
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Guidelines for evaluation and testing of H. pylori antibiotic resistance |
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Guidelines for when to test for treatment success after H. pylori eradication therapy |
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Guidelines for penicillin allergy in patients with H. pylori infection |
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Peptic ulcer laboratory tests On the Web |
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American Roentgen Ray Society Images of Peptic ulcer laboratory tests |
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Risk calculators and risk factors for Peptic ulcer laboratory tests |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
- Etiological classification of peptic ulcers:[1]
- Positive for Helicobacter pylori infection.
- Drug NSAID-induced.
- Helicobacter pylori and NSAIDs positive.
- H. pylori and NSAIDs negative (requires search for other causes).
- Approach of patients <55 years, depending of the H. pylori (H. pylori) prevalence (≥10%):[2]
- Test and treat for H. pylori using a validated noninvasive test and a trial of acid suppression if eradication is successful but symptoms do not resolve OR
- Empiric trial of acid suppression with a proton pump inhibitor (PPI) for 4-8 weeks.
Laboratory Findings
The methods of diagnostic testing for Helicobacter pylori can be classified into those that do and those that do not require endoscopy:[3]
- Breath testing (does not require EGD);*Direct culture from an EGD biopsy specimen;
- Direct detection of urease activity in a biopsy specimen;
- Measurement of antibody levels in blood (does not require EGD). It is still somewhat controversial whether a positive antibody without EGD is enough to warrant eradication therapy.
The possibility of other causes of ulcers, notably malignancy (gastric cancer) needs to be kept in mind. This is especially true in ulcers of the greater (large) curvature of the stomach; most are also a consequence of chronic H. pyloriinfection.
References
- ↑ Malfertheiner P, Chan FK, McColl KE (2009). "Peptic ulcer disease". Lancet. 374 (9699): 1449–61. doi:10.1016/S0140-6736(09)60938-7. PMID 19683340.
- ↑ Talley NJ, Vakil N, Practice Parameters Committee of the American College of Gastroenterology (2005). "Guidelines for the management of dyspepsia". Am J Gastroenterol. 100 (10): 2324–37. doi:10.1111/j.1572-0241.2005.00225.x. PMID 16181387.
- ↑ Chey WD, Wong BC, Practice Parameters Committee of the American College of Gastroenterology (2007). "American College of Gastroenterology guideline on the management of Helicobacter pylori infection". Am J Gastroenterol. 102 (8): 1808–25. doi:10.1111/j.1572-0241.2007.01393.x. PMID 17608775.