Testing and treating  H. Pylori

 

NICE CG27 : Dyspepsia - management of dyspepsia in adults in primary care

Resources for patients

Investigating H Pylori Checklist


  1. Bullet Off PPI or alternative for 2 weeks

  2. Bullet No antibiotics for 4 weeks

  3. Bullet Fasting for a minimum of 8 hr

  4. Bullet Can use OTC antacids

  5. Bullet  Attend with 200ml of pure orange

NICE GUIDANCE ON H. PYLORI TESTING AND ERADICATION

Recommendations


  1. H Pylori can be initially detected using the carbon-13 urea breath test or a stool antigen test, or laboratory based serology where its performance has been locally validated

  2. Re-testing for H Pylori should be performed using a carbon-13 urea breath test. ( There is currently insufficient evidence to recommend the stool antigen test as a test of eradication.)

  3. Office based serological tests for H Pylori cannot be recommended because of their inadequate performance


  1. For patients who test positive, provide

  2. a 7-day twice a day course of treatment consisting of a full dose PPI

  3. with metronidazole 400mg and clarithromycin 250mg

  4. or amoxycillin 1g and clarithromycin 500mg

  5. For patients who require a second course of eradication therapy, a regimen should be chosen that does not include antibiotics given previously