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|Helicobacter pylori-associated Peptic
Infection with H. pylori is a necessary cofactor for the overwhelming majority of duodenal and gastric ulcers not associated with NSAIDs; more than 90% of patients with duodenal ulcer have H. pylori chronic gastritis.
The natural history of peptic ulcer disease is well defined. After standard therapy with H2-antagonists or sucralfate, 70% to 85% of affected patients per year have a recurrence. One half of these are asymptomatic.
Patients with active ulcers should have antral biopsies taken at endoscopy. If histologic examination shows normal mucosa, NSAIDs or hypersecretory states are more likely possibilities than H. pylori infection. However, because approximately one half of patients taking chronic NSAID therapy who develop ulcers also have chronic H. pylori gastritis, the cause of the ulcer may be unclear.
THERAPY FOR HELICOBACTER PYLORI:
The current 10-day regimen with
ACP Library on Disk 2- (c) 1997 - American College of Physicians