Recurrent H. pylori infection is a condition characterized by the repeated occurrence of H. pylori infection in an individual. H. pylori is a bacterium that infects the stomach lining, leading to various gastrointestinal symptoms such as dyspepsia, nausea, and upset stomach. In the case of M.C., a 46-year-old Hispanic female, she presents to the GI clinic complaining of recurrent H. pylori infection.
M.C. had previously undergone H. pylori triple therapy, but it failed to eradicate the infection. She also reports that her symptoms of dyspepsia have been worsening over the past two months. Dyspepsia refers to a condition where individuals experience pain or discomfort in the upper abdomen, often associated with other symptoms like nausea or upset stomach.
In terms of the patient’s medical history, M.C. has a past medical history of dyspepsia and gastroesophageal reflux disease (GERD). GERD is a condition where stomach acid flows back into the esophagus, causing symptoms such as heartburn. It is possible that GERD and dyspepsia are related to the recurrent H. pylori infection.
M.C. denies experiencing symptoms such as hematochezia (blood in the stool), melena (black, tarry stools), hemoptysis (coughing up blood), abdominal pain, fever, chills, or any other symptoms. This information suggests that the infection may be localized in the stomach and not causing complications in other parts of the gastrointestinal tract.
The patient’s demographics reveal that she is a 46-year-old Hispanic female, married, with no children. She frequently eats out in restaurants and consumes one 4-ounce glass of red wine daily. It is important to note these lifestyle factors as they can influence the development and management of H. pylori infection. Smoking history is also noted, with the patient being a former smoker who stopped three years ago. This cessation of smoking is a positive factor in reducing the risk of complications associated with H. pylori infection.
Family history includes a father with a history of type 2 diabetes mellitus (DM), Tinea Pedis (fungal infection of the feet), and a mother with a history of atopic dermatitis, tinea corporis (ringworm), and tinea pedis. While these family medical histories may not directly relate to H. pylori infection, they provide a broader understanding of the patient’s overall health background.
A physical examination of M.C. reveals no signs of fever, chills, shortness of breath (respiratory symptoms), edema or palpitations (cardiovascular symptoms). Gastrointestinal examination shows no vomiting, abdominal distention, or tenderness. Bowel sounds are present in all four quadrants. The patient’s height is recorded as 5 feet 5 inches, weight as 140 pounds, BMI as 31 (indicating obesity), and blood pressure as 110/70. No abnormal findings are noted in the laboratory results, including hemoglobin, hematocrit, potassium, sodium, serum creatinine, AST/ALT, TSH, and glucose levels.
To further investigate the H. pylori infection, the patient underwent an esophagogastroduodenoscopy (EGD) two weeks ago, which revealed H. pylori positive gastritis in the biopsy results. The urea breath test, which measures the presence of H. pylori in the stomach, was recommended for eight weeks after treatment with H. pylori medications. However, prior to the urea breath test, the patient needs to stop taking proton pump inhibitors (PPIs) for two weeks. No new laboratory tests are currently required.
Based on the information provided, it is recommended that the patient continue the current medication therapy given for two weeks and return to the office in eight weeks for symptom reevaluation. The management of H. pylori infection is guided by evidence-based guidelines such as the American College of Gastroenterology’s Management of H. pylori infection guideline, which provides detailed recommendations for the diagnosis and treatment of H. pylori infection.
