Peptic ulcer laboratory tests: Difference between revisions

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==Overview==
==Overview==
*Etiological classification of peptic ulcers:<ref name="pmid19683340">{{cite journal| author=Malfertheiner P, Chan FK, McColl KE| title=Peptic ulcer disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9699 | pages= 1449-61 | pmid=19683340 | doi=10.1016/S0140-6736(09)60938-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683340  }} </ref>
*Etiological classification of peptic ulcers:<ref name="pmid19683340">{{cite journal| author=Malfertheiner P, Chan FK, McColl KE| title=Peptic ulcer disease. | journal=Lancet | year= 2009 | volume= 374 | issue= 9699 | pages= 1449-61 | pmid=19683340 | doi=10.1016/S0140-6736(09)60938-7 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19683340  }} </ref>
**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 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 ''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>
*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>

Revision as of 19:38, 3 June 2014

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Peptic ulcer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Peptic Ulcer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Upper GI Endoscopy

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Endoscopic management
Surgical management

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

2017 ACG Guidelines for Peptic Ulcer Disease

Guidelines for the Indications to Test for, and to Treat, H. pylori Infection

Guidelines for First line Treatment Strategies of Peptic Ulcer Disease for Providers in North America

Guidlines for factors that predict the successful eradication when treating H. pylori infection

Guidelines to document H. pylori antimicrobial resistance in the North America

Guidelines for evaluation and testing of H. pylori antibiotic resistance

Guidelines for when to test for treatment success after H. pylori eradication therapy

Guidelines for penicillin allergy in patients with H. pylori infection

Guidelines for the salvage therapy

Peptic ulcer laboratory tests On the Web

Most recent articles

cited articles

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Echo & Ultrasound
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Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Peptic ulcer laboratory tests

CDC on Peptic ulcer laboratory tests

Peptic ulcer laboratory tests in the news

Blogs on Peptic ulcer laboratory tests

to Hospitals Treating Peptic ulcer

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.
    • H. 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 H. 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

  1. 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.
  2. 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.
  3. 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.


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