Monday, March 14, 2011

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H. Pylori - diagnosis and treatment

We usually use the serological test ( anti H. Pylori anti bodies ) to test for the presence of the micro organism in our setting. But unfortunately this least expensive method is also the least accurate one. The sensitivity of this test is 85% while its specificity is only 79%.
The more accurate tests with a sensitivity and specificity of around 95% include:
1) Urea breath test,
2) Fecal antigen test.

Sensitivity refers to the % of ill persons who are correctly identified as having a particular disease.
Specificity refers to the % of healthy persons who are correctly identified as not suffering from a particular disease.

Eradication treatment that we usually use includes a PPI (proton pump inhibitor) and 2 antibiotics for 14 days, the regimen with the greatest proven efficacy. It includes:
1) Cap Omeprazole 20 mg B.D +
2) Tab Clarithromycin 500 mg B.D +
3) Cap Amoxicillin 1 g B.D or Tab Metronidazole 500 mg B.D if allergic to amoxicillin.


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