A 35-year-old Nigerian born female presents with burning in her epigastric region. Ultimately, esophagoduodenoscopy (EGD) demonstrates an ulcer in the proximal duodenum. Which of the following treatments would best address the cause of her ulcer?
1.Antibiotics
2.Cessation of NSAID use
3.Surgical resection
4.Cimetidine
5.Omperazole
Summary
Based on the patient’s presentation and the finding of a duodenal ulcer, the most likely cause is an H. pylori infection (most common cause of peptic ulcer disease). Therefore, antibiotics would be the best treatment.
H. pylori is a spiral-shaped bacterium that is able to colonize the mucus of gastric cells. This can lead to areas of compromised mucus protection. H. pylori infection is also associated with increased production of acid. Combined, this can mediate the formation of peptic ulcers. Initial treatment includes the use of antibiotics, which also helps to eradicate the subsequent symptoms of peptic ulcer disease. The goal of antibiotic treatment is the elimination of the bacteria from the stomach.
Illustration A depicts an overview image of duodenal and gastric ulcers. Illustration B shows an actual image of a duodenal ulcer seen on an upper GI endoscopy (EGD - esophagogastroduodenoscopy). Illustration C depicts the pathophysiology of H. pylori.