Helicobacter pylori infection history and symptoms: Difference between revisions

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{{Helicobacter pylori infection}}
{{Helicobacter pylori infection}}
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{{CMG}} {{AE}}{{YK}}


==History and Symptoms==
==Overview==
* The most common [[ulcer]] symptom is gnawing or burning pain in the [[abdomen]] between the breastbone and the belly button.
Specific areas of focus when obtaining a history from the patient include history of [[nausea]], [[vomiting]], [[epigastric|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 pain|epigastric]] or [[abdominal pain]], [[bloating]], [[belching]], dark or tarry like stools ([[melena]]), [[fatigue]], [[diarrhea]] and unexplained weight loss.
* The pain often occurs when the stomach is empty, between meals and in the early morning hours, but it can occur at any other time.
 
* It may last from minutes to hours and may be relieved by eating food or taking antacids.
==History==
* Less common symptoms include [[nausea]], [[vomiting]], or [[loss of appetite]]. Sometimes ulcers bleed. If bleeding continues for a long time, it may lead to [[anemia]] with [[weakness]] and [[fatigue]]. If [[bleeding]] is heavy, [[blood]] may appear in vomit or bowel movements, which may appear dark red or black.
Specific areas of focus when obtaining a history from the patient include history of:<ref name="pmid16847081">{{cite journal| author=Kusters JG, van Vliet AH, Kuipers EJ| title=Pathogenesis of Helicobacter pylori infection. | journal=Clin Microbiol Rev | year= 2006 | volume= 19 | issue= 3 | pages= 449-90 | pmid=16847081 | doi=10.1128/CMR.00054-05 | pmc=1539101 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16847081  }} </ref><ref name="pmid25278678">{{cite journal| author=Testerman TL, Morris J| title=Beyond the stomach: an updated view of Helicobacter pylori pathogenesis, diagnosis, and treatment. | journal=World J Gastroenterol | year= 2014 | volume= 20 | issue= 36 | pages= 12781-808 | pmid=25278678 | doi=10.3748/wjg.v20.i36.12781 | pmc=4177463 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25278678  }} </ref><ref name="pmid24587620">{{cite journal| author=Garza-González E, Perez-Perez GI, Maldonado-Garza HJ, Bosques-Padilla FJ| title=A review of Helicobacter pylori diagnosis, treatment, and methods to detect eradication. | journal=World J Gastroenterol | year= 2014 | volume= 20 | issue= 6 | pages= 1438-49 | pmid=24587620 | doi=10.3748/wjg.v20.i6.1438 | pmc=3925853 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24587620  }} </ref>
*[[Nausea]] & [[vomiting]]
*[[Epigastric pain|Epigastric]] or [[abdominal pain]]
*[[Bloating]]
*Pain aggravating or relieving with food
*[[Gastrointestinal bleeding]]
*[[Anorexia]]
*Weight loss
*[[Pallor]]
*Previous laboratory findings of [[anemia]]
*A positive family history of GI diseases or ''[[H. pylori]]'' infection
*History of medication use ([[NSAIDS]])
*Food and drinking water hygiene
 
If ''[[H. pylori]]'' infection is suspected in children, the history of the patient should include:
*[[Pain]] (location, character, duration, radiation, severity, aggravating and relieving factor)
*Diet, [[appetite]] and weight changes
*[[Nausea]]
*[[Vomiting]]
*[[Bloating]]
*A positive family history of Gastrointestinal diseases (eg., [[Ulcers]], [[crohn's disease]]) or ''[[H. pylori]]'' infection
*History of [[NSAIDS]] use
*Food and drinking water hygiene
 
==Symptoms==
Majority of patients infected are asymptomatic. Symptoms of ''[[H. pylori]]'' infection include:
*[[Halitosis]]
*[[Nausea]]
*[[Vomiting]]
*[[Epigastric pain|Epigastric]] or [[abdominal pain]]
*[[Bloating]]
*[[Belching]]
*Early [[satiety]]
*Dark or tarry like stools ([[melena]])
*[[Fatigue]]
*[[Diarrhea]]
*Unexplained weight loss
 
===Functional dyspepsia===


Functional dyspepsia: Rome III diagnostic criteria for gastrointestinal disorders
Functional dyspepsia: Rome III diagnostic criteria for gastrointestinal disorders
Line 13: Line 51:
B1. FUNCTIONAL DYSPEPSIA
B1. FUNCTIONAL DYSPEPSIA


Diagnostic criteria Must include:<ref name=dyspepsia>Annals of Gastroenterology http://www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf Accessed on January 9, 2017 </ref>
Diagnostic criteria Must include:<ref name=dyspepsia>Rome III diagnostic criteria http://www.romecriteria.org/assets/pdf/19_RomeIII_apA_885-898.pdf Accessed on January 9, 2017 </ref>


1: One or more of the following:
1: One or more of the following:
:*Bothersome postprandial fullness  
:*Bothersome postprandial fullness  
:*Early satiation
:*Early [[satiety]]
:*Epigastric pain
:*[[Epigastric pain]]
:*Epigastric burning
:*Epigastric burning
And
And
2: No evidence of structural disease (including at upper endoscopy) that is likely
 
2: No evidence of structural disease (including at upper [[endoscopy]]) that is likely
to explain the symptoms
to explain the symptoms


Criteria fulfilled for the last 3 months with symptom onset
*Criteria fulfilled for the last 3 months with symptom onset
at least 6 months prior to diagnosis
at least 6 months prior to diagnosis
====Dyspepsia Approach====
Approach to the management of dyspeptic patients
{{Family tree/start}}
{{Family tree | | | | B01 | | | |B01= Dyspeptic patient <br> First primary care visit}}
{{Family tree | |,|-|-|^|-|-|.| | }}
{{Family tree | C01 | | | | C02 |C01= <45 years* without alarm symptoms|C02= >45 years or with alarm symptoms irrespective of age}}
{{Family tree | |!| | | | | |!| | }}
{{Family tree | C01 | | | | C02 |C01= Review patient's history <br> Test for ''[[Helicobacter pylori]]'' <br> 13C UBT <br> or <br> Laboratory serology| C02= Refer to gastroenterologist}}
{{Family tree | |!| | | | | | | | }}
{{Family tree | C01 | | | | | | |C01= If ''[[H.pylori]]'' positive, treat the infection|}}
{{Family tree/end}}Adopted from Gut 1997 Jul; 41(1): 8–13.<ref name="pmid9274464">{{cite journal| author=| title=Current European concepts in the management of Helicobacter pylori infection. The Maastricht Consensus Report. European Helicobacter Pylori Study Group. | journal=Gut | year= 1997 | volume= 41 | issue= 1 | pages= 8-13 | pmid=9274464 | doi= | pmc=1027220 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9274464  }} </ref>
* The cutoff value may be below 45 years of age depending on regional differences in the incidence of gastric malignancy


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WS}}
[[Category:Disease]]
[[Category:Infectious disease]]
[[Category:Gastroenterology]]
[[Category:Needs overview]]

Latest revision as of 14:48, 24 January 2017

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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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