H. pylori infection is causally linked to gastritis, PUD, and gastric malignancy. Understanding the role of this microorganism in gastroduodenal disorders continues at a rapid pace because of the tremendous number of investigations in progress around the world. Good management guidelines are available for PUD, but controversy remains about screening for H. pylori in the patient beginning NSAIDs or in the patient who has been on NSAIDs. Although this

TABLE 23-2. FDA-Approved Eradication Regimens for Helicobacter pylori Infection

Bismuth-Metronidazole-Tetracycline (Helidac) therapy for 14 days Pepto Bismol 2 tabs po qid Metronidazole 250 mg po qid Tetracycline 500 mg po qid Plus H2RA for 8 weeks or PPI for 4 to 6 weeks

PPI-bid triple therapy for 10 or 14 days Omeprazole (Prilosec) 20 mg or Lansoprazole (Prevacid) 30 mg po bid (Prevpac) Amoxicillin (Amoxic) 1 g po bid Clarithromycin (Biaxin) 500 mg bid

PPI bid triple therapy for 7 days Rabeprazole (Aciphex) 20 mg po bid Amoxicillin (Amoxic) 1 g po bid Clarithromycin (Biaxin) 500 mg bid

PPI qd triple therapy for 10 days Esomeprazole (Nexium) 40 mg qd Amoxicillin (Amoxic) 1 g po bid Clarithromycin (Biaxin) 500 mg bid bid = twice daily; FDA = US Food and Drug Administrtion; H2RA = histamine-2 receptor antagonist; po = by mouth; PPI = proton pump inhibitor; qd = every day; qid = four times daily.

infection has been labeled as a definite carcinogen, screening for this ubiquitous infection does not appear to be cost effective in the general US population. Benefit of eradication in the NUD patient continues to be uncertain, but recent studies indicate a small therapeutic gain for sustained symptom improvement in these patients. H. pylori infection and associated clinical disorders remains a complex and controversial subject. Disparate conclusions are often based on differences in population demographics and study designs. Management strategies have been based on guidelines from consensus conferences, but these strategies must remain flexible as new study findings become available.

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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