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A patient, 56 years old, diagnosed with duodenal ulcer 6 months ago. Biopsy showed the presenc of Helicobacter pylori, which was treated with amoxicillin, clarithromycin and omeprazole. After treatment, the patient remained to complain burning symptoms even taking omeprazole. In a new investigation, two tests were done: rapid urease test which was negative and serology for H. pylori which was positive.

- Do you suggest new treatment for H. pylori?

Do you suggest surgery for this patient?

What are the surgical options for this case?

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The serology is highly sensitive test but if a person had a previous H Pylori infection, it will be be positive.

The urease breath test turning from positive to negative indicates that the patient has responded to the OAC regimen.  

First thing I would like to ask the patient whether the symptoms have improved. If the symptoms persist as seen in this case,  reevaluate the patient for Zollinger Ellison syndrome.

Thanks Alam for the paper.

Than I would try BMT regime first.

What is the serology test for H.pylori, is it antiH.pylori IgG or IgM?

Please give expanded forms of OAC, BMT and LAC.



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