Diagnosis method of Helicobacter pylori infection in bleeding peptic ulcer.
Peptic ulcer lesions are the most frequent cause of upper gastrointestinal bleeding and are responsible for more than 50 per cent of cases. Several etiologic factors of peptic ulcer are known, the principle one being Helicobacter pylori (H. pylori). Recent studies indicate that H. pylori eradication is associated with the marked reduction in rebleeding rate. In peptic ulcer bleeding which requires surgical intervention, knowledge H. pylori status may help to determine the choice of procedure (simple sewing in H. pylori positive patients vs full-blown ulcer surgery in H. pylori negative patients). We suggest to use the invasive combination of histology and biopsy-rapid urease test in stable bleeding peptic ulcer patients without coagulopathy for H. pylori diagnosis. Cases with positive result do not need further investigation for H. pylori diagnosis. If negative, the serology test was suggested to confirm the absence of H. pylori. However, in unstable patients, the serology test seem to effectively detect H. pylori infection.
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Varocha
V
Mahachai
Ratha-Korn
RK
Vilaichone
Pinit
P
Kullavanijaya
D001707:Biopsy, Needle; D001944:Breath Tests; D015169:Colony Count, Microbial; D003470:Culture Media; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology*; D005773:Gastroscopy / Q000379:methods*; D016481:Helicobacter Infections / Q000175:diagnosis*; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis / Q000382:microbiology*; D016133:Polymerase Chain Reaction / Q000379:methods; D012680:Sensitivity and Specificity; D014510:Urease / Q000032:analysis*
D003470:Culture Media; D014510:Urease