Answers
1) Rapid urease test
2) Steps
a) Peel back the adhesive cover
b) Place one or more biopsy specimen on the test yellow dote, reseal and press the label over the dot with your finger to squeeze the tissue juice out of specimen.
c) Monitor the result after one minute and up to 60 minutes
3) The basis of the test is the ability of H. pylori to secrete the urease enzyme, which catalyzes the conversion of urea to ammonia and bicarbonate.
4) Interpretation of the test
a) Positive result may indicate the presence of H. pylori organism
5) Management of H. pylori induced peptic ulcer disease
a) Giving the triple therapy for one to two weeks consisting of 2 antibiotics and one proton pump inhibitors, for examples
- Tablet Omeprazole 0.8 mg/kg daily (approximately 40 mg In adult)
- Tablet Metronidazole 8mg/kg tds (approximately 400 mg in adult)
- Tablet amoxicillin 10mg/kg tds (approximately 500 mg in adults)
- Or, Metronidazole can be replaced with tab clarithromycin 7.5-15 mg/kg bds.
b) If the triple therapy fails to eradicate the H. pylori, may use quadruple therapy
- Omeprazole (0.8 mg/kg daily) + Bismuth subsalicylte (107.7 mg X 4d and nocte for 2 weeks) + Tab. Tetracycline (500 mg bds X 4d) + Metronidazole (200 mg with meals and 400 mg nocte)
c) Withdrawal of any offensive drugs like NSAIDs
d) May add drug for mucosal protective barrier like Sucralfate or antacids like MMT.