2017-02-01 19:48:13 UTC

How Do You Approach Refractory H. Pylori?

Feb. 1, 2017

AGA Perspectives piece dives into the ups and downs of treating this bacterial infection.

In the current AGA Perspectives issue, Nimish B. Vakil, MD, AGAF, outlines some important steps to helping patients with difficult cases of Helicobacter Pylori (H. pylori). 

One of the first steps is determining if the refractoriness is real. "Successfully cured patients are sometimes referred to specialists because of positive serology tests. A stool antigen test or a breath test rapidly resolves this issue. The patient may not adhere to the treatment regimen. In some randomized controlled trials, 30 percent of failures were attributed to poor adherence with the regimen," he writes. 

Among Dr. Vakil's current go-to treatments for many of the patients who end up having refractory H. pylori is non-bismuth based quadruple therapy for 14 days as a primary regimen. "Extending the duration of treatment to 14 days improves eradication rates but I fully expect that some patients will not make it beyond 10 days and I like the additional buffer," he adds.

How to do you approach difficult-to-treat H. pylori? Share your thoughts on Twitter by tagging our editor, Dr. Gary Falk, or write a post in AGA Community.

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