Peptic ulcer esophagogastroduodenoscopy

Peptic ulcer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Peptic Ulcer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Upper GI Endoscopy
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery Endoscopic management Surgical management
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
2017 ACG Guidelines for Peptic Ulcer Disease
Guidelines for the Indications to Test for, and to Treat, H. pylori Infection
Guidelines for First line Treatment Strategies of Peptic Ulcer Disease for Providers in North America
Guidlines for factors that predict the successful eradication when treating H. pylori infection
Guidelines to document H. pylori antimicrobial resistance in the North America
Guidelines for evaluation and testing of H. pylori antibiotic resistance
Guidelines for when to test for treatment success after H. pylori eradication therapy
Guidelines for penicillin allergy in patients with H. pylori infection
Guidelines for the salvage therapy
Peptic ulcer esophagogastroduodenoscopy On the Web
Most recent articles
cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Peptic ulcer esophagogastroduodenoscopy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Peptic ulcer esophagogastroduodenoscopy
CDC on Peptic ulcer esophagogastroduodenoscopy
Peptic ulcer esophagogastroduodenoscopy in the news
Blogs on Peptic ulcer esophagogastroduodenoscopy
to Hospitals Treating Peptic ulcer
Risk calculators and risk factors for Peptic ulcer esophagogastroduodenoscopy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ;Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Peptic ulcer esophagogastroduodenoscopy

American College of Gastroenterology (ACG) guidelines 2017 for the treatment of H pylori infection (HPI) include the following recommendations for testing for H pylori:

• Active or past history of peptic ulcer disease.
• Low-grade gastric mucosa-associated lymphoid tissue (MALT) lymphoma
• Confirmed history of PUD (not previously treated for H. pylori)
• Long-term therapy with nonsteroidal anti-inflammatory agents (NSAIDs) and low-dose aspirin
• Unexplained iron deficiency anemia following standard workup
• Idiopathic thrombocytopenic purpura

Algorithm for the Approach to Dyspepsia

Age ≥ 55 or ⊕ alarm features?

YES

NO

Endoscopy

H. pylori prevalence?

High

Low

Test-and-treat strategy ± acid suppression

Acid suppression trial

If eradication therapy is indicated

Clarithromycin resistance ≥ 20%

Clarithromycin resistance < 20%

Quadruple or sequential therapy

PCA or PCM or Bismuth quadruple therapy

PLA

Bismuth quadruple therapy or PLA

Adjust Rx per susceptibility test

Consider endoscopy if treatment fails