| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
|
Statistical
association of H. pylori and peptic ulcer disease.
-
Infection is present in virtually
all patients with duodenal ulcers.
-
Infection is present in 70%
of those with gastric ulcers.
-
Antibiotic treatment removing
H.
pylori, substantially improves rate of healing and prevents recurrence.
So what does the bug do to cause
the damage?
-
Secretes a urease which
generates free ammonia, and a protease which breaks down glycoproteins
in the gastric mucus.
-
Neutrophils attracted to the
presence of H. pylori release myeloperoxidase which produces hypochlorous
acid, eventually yielding monochloramine in the presence of free ammonia.
Both hypochlorous acid and monochloramine are known to destroy gastric
mucosal cells.
H.
pylori continued. |
|