GASTROENTEROLOGY ARTICLE OF THE WEEK

NOVEMBER 2, 2000

 Peterson WL, Fendrick AM, Cave DR, et al.  Helicobacter pylori-related disease.  Guidelines for testing and treatment.  Arch Intern Med 2000;160:1285-1291.

 1.  Testing for H. pylori should be performed in which of the following circumstances

            a.  duodenal or ulcer disease

            b.  use of NSAID’s

            c.  generalized abdominal pain and bloating

            d.  general population screening to reduce risk of gastric cancer

            e.  individuals with a strong family history of gastric adenocarcinoma

            f.   individuals with MALT lymphoma

 2.  The percentage of patients in the U.S. with a duodenal ulcer who test positive for H. pylori is:

            a. 95%

            b. 40%

            c. 100%

            d. 75%

 True or False

 3.  Primary H. pylori resistance to metronidazole in the U.S. is approximately 28% to 39%.

 4.  H pylori increases risk for adenocarcinoma of the stomach 9-fold.

5.  Stool antigen tests for H. pylori have a sensitivity and specificity similar to urea breath test for the initial diagnosis of H. pylori infection as well as for assessing eradication after treatment.

 6.  H pylori resistance to amoxicillin or tetracycline is rare, resistance to clarithromycin is approximately 11%.

 7.  If a patient with a duodenal ulcer by EGD has a negative RUT, lack of H. pylori infection should be assumed and the patient does not need additional evaluation.

 8.  A 62-year-old person with dyspepsia who is H. pylori positive should be eradicated without the need for diagnostic endoscopy.

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