Case Study 281116 - Persistent H.Pylori InfectionCreated by:
A middle age lady, with background of hypertension, type 2 diabetes mellitus, peptic ulcer disease, was initially referred for an OGD (gastroscopy), due to increasing epigastric pain that was not improved with proton pump inhibitor, with abdominal bloating, reduced in appetite, and intermiitent feeling of needing extra effort to swallow food (no definite dysphagia). OGD was done showed mild gastritis, and mild duodenitis, with a positive Clo-test. No ulcer seens during the OGD. She was given a course of triple therapy (amoxicillin, clarithromycin, and PPI) for eradication of her Helicobacter Pylori infection. She was followed up in outpatient around 8 weeks after, with persistent symptoms after the course of antibiotic. UBT (urea breath test) was done which showed a positive result. How would you treat her now ?? What potential regimen to use to eradicate the H.Pylori ??