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]

If H. pylori infection is suspected in children, the history of the patient should include:

Symptoms

Majority of patients infected are asymptomatic. Symptoms of H. pylori infection include:

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:

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

  1. 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.
  2. 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.
  3. 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.
  4. Rome III diagnostic criteria http://www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf Accessed on January 9, 2017
  5. "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.

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