Helicobacter pylori duodenal ulcer — ESEGH MCQ
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Correct answer: E — Eradicate H. pylori, give PPI treatment and review the need for naproxen or gastroprotection
The best answer is “Eradicate H. pylori, give PPI treatment and review the need for naproxen or gastroprotection”. Management treats the infection and acid injury while also addressing the continuing NSAID risk. “No treatment because a clean base has low rebleeding risk” is less appropriate because low immediate rebleeding risk does not remove the ulcer aetiology “Continue naproxen without gastroprotection after eradication” is less appropriate because ongoing NSAID exposure remains an important recurrent-ulcer risk “Immediate gastrectomy” is less appropriate because an uncomplicated clean-base duodenal ulcer does not require surgery “Oral mesalazine as ulcer-healing therapy” is less appropriate because mesalazine does not eradicate H. pylori or treat peptic ulcer disease
Reference: NICE CG184 dyspepsia and GORD: https://www.nice.org.uk/guidance/cg184/chapter/Recommendations