H. Pylori infection

GI Case Study:

Chief grievance: “I accept reiterated H. Pylori contagion”.

HPI: M.C. a 46-year-old Hispanic feminine presents to the GI clinic for grievance of reiterated H. Pylori contagion. She was treated encircling 2 ½ months ago delay H. Pylori triple therapy and failed composition. She has PMH of dyspepsia, and GERD. She so indicates that she has noticed that her symptoms of dyspepsia are worsening for elapsed 2 months. She has associated her symptoms delay disgust, overbalance stomach delay all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal refusal, ferment, chills, refusal or any other symptoms.

PMH:

H. Pylori contagion gastritis

Diabetes Mellitus, mark 2

Surgeries: None

Allergies: NKDA

Vaccination History: Up-to-date

Social fact:

High ground graduate, married and no chattels. He regularly eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a ancient smoker that plugped 3 years ago.

Family fact:

Both parents are existing. Father has fact of DM mark 2, Tinea Pedis. Mother existing and has fact of atopic dermatitis, tinea corporis and tinea pedis.

ROS:

Constitutional: Negative for ferment. Negative for chills.

Respiratory: No Shortness of life. No Orthopnea.

Cardiovascular: No edema. No palpitations.

Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal refusal.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 plumpness, BP 110/70 T 98.0 po P 80 R 22, non-labored

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Usual contour; No evident masses.

Labs day of visit:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine usual 1.0, AST/ALT usual. TSH 3.7 usual, glucose 98 usual

Assessment:

Primary Diagnosis: Recurrent H. Pylori contagion gastritis

Secondary Diagnoses: Dyspepsia

Differential Diagnosis: Peptic Ulcer Disease

Previous medication plan: two months ago and failed.

  1. Clarithromycin      500 mg po BID for 2 weeks
  2. Omeprazole      40 mg po BID for 2 weeks and then po daily.
  3. Cipro      500 mg po BID for 2 weeks

Plan: Tests

Pt had EGD executed 2 weeks ago that showed H. Pylori indisputable gastritis in biopsy results.

Urea life trial 8 weeks following composition delay H. Pylori medications. Pt needs to plug PPI’s 2 weeks antecedent to Urea Life trial.

Labs: No new labs are needed.  

Referrals: may allude naturalized on chattels of medication therapy absorbed for 2 weeks.

Follow up: recur to station in 8 weeks to reevaluate symptoms.

As a advenient nourish practitioner, it is main that you determine the medications used for reiterated H. Pylori contagion.

Please sift-canvass new therapy guidelines for H. Pylori composition, and produce enduring teaching.

Below is the website for the American Academy of Gastroenterology Clinical Guidelines (ACG) for the updated H. Pylori therapy. Feel operating to advise-with other peer-reviewed subscription delayin 5 years of divulgation.

Total of 2 support needed. 1 judicious and 1 answer.

http://gi.org/wp-content/uploads/2017/02/ACGManagementofHpyloriGuideline2017.pdf
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