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Update on Practical Point in Dyspepsia/GERD Management
Pariet
สร้างโดย ณัฐพงศ์ ศิริวงสเถียร เมื่อ 24 ส.ค. 2561

Q1Do you test H. pylori infection in this patient ?
Yes
No

Q2If CLO test was positive, which regimen do you prefer?
Triple therapy (PPI, clarithromycin, and amoxicillin)  for 7 days
Triple therapy for 14 days
Sequential therapy (PPI and amoxicillin for 5 days followed by PPI, clarithromycin, and metronidazo
Bismuth quadruple therapy (PPI, bismuth, tetracycline, and metronidazole) for 10-14 days
Concomitant therapy (PPI, clarithromycin, amoxicillin and metronidazole) for 10–14 days 

Q3How to manage?
Rebamipide (mucosta®)
Change anxiolytic drug
Change antidepressant drug
Antacid (prn)
Change PPI
consult psychiatrist

Q4How to manage in this patient?
EGD
Change another PPI (Twice daily)
Change another PPI (standard dose-once daily)
24 hr pH monitoring
Esophageal manometry
Multichannel intraluminal impedance and ambulatory pH (MII-pH)

Q5Do you treat H. pylori infection in this patient ?
No
Yes

Q6How to manage in this patient?
PPI (Twice daily)
Standard dose PPI (once daily)
24 hr pH monitoring
Esophageal manometry
Multichannel intraluminal impedance and ambulatory pH (MII-pH)