endoscopic biopsies for H Pylori infection to rule out gastric cancers

This patient presents with symptoms of peptic ulcer disease likely from Helicobacter pylori infection, a common cause of gastric and duodenal ulcers.  Peptic ulcer disease is also strongly associated with gastric cancers (40%) and primarily gastric mucosa-associated lymphoid tissue lymphomas.  H pylori infection also can lead to chronic gastritis and intestinal metaplasia and is more common in individuals from East Asia and certain parts of Latin America.  Thus, obtaining multiple biopsies for histology is generally recommended.

Eradication of H pylori (triple-based therapy) also appears to reduce the risk of gastric cancer in certain high-risk individuals.  Endoscopy may be repeated in 6 weeks after completion of therapy if the ulcer biopsy was inadequate or in patients at high risk for malignancy (Table).

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