1/3. H pylori infection. review of the guideline for diagnosis and treatment.helicobacter pylori infection is prevalent among persons over age 60, is strongly associated with peptic and duodenal ulcer, and is caused by a microbe classified as a carcinogen. These factors combine to make the primary care physician key to proper diagnosis and treatment of H pylori infection. In 1998, the American College of gastroenterology published an evidence-based guideline for the management of this infection. The guideline produced several fundamental recommendations that help clarify the management process: asymptomatic persons should not undergo testing, but testing should be performed on certain persons, testing should only be done if the intention is to treat; the choice of test is governed by the need for endoscopy; and several triple-therapy regimens are effective for eradication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/3. halitosis and helicobacter pylori. A possible link?The exact pathophysiological mechanism of halitosis is not clear, and in many patients the etiology is an enigma. We followed three couples in which one member or both had halitosis. All the subjects had evidence of helicobacter pylori infection. All received a treatment course of colloidal bismuth subcitrate four times a day and 250 mg metronidazole three times a day. There was impressive improvement in their symptoms, the halitosis disappearing along with eradication of the organism. We call the attention of physicians to the possible connection between halitosis, H. pylori infection, and familial occurrence. Further studies to confirm this surprising association are in order.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/3. clostridium difficile colitis associated with treatment of helicobacter pylori infection.helicobacter pylori infection of the stomach is being detected and treated more often now than ever before. This is likely to result in an increase in complications such as antibiotic-associated diarrhea. However, there is no literature on the incidence of such diarrhea, particularly clostridium difficile colitis, in patients treated for helicobacter pylori infection. We report the case of a patient who developed clostridium difficile colitis after treatment for helicobacter pylori infection with metronidazole, amoxicillin, H2 blockers, and bismuth subsalicylate. This patient presented with severe diarrhea that responded to a course of metronidazole with rapid disappearance of symptoms. The incidence of clostridium difficile colitis in patients treated for helicobacter pylori infection has not been studied. This unique association, although not unexpected, has not yet been reported in the literature. The increasing number of patients being diagnosed and treated for this infection requires a heightened awareness on the part of physicians, to assure early diagnosis and treatment of this treatable, yet potentially dangerous, complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |