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Gastroenterology


Answer 3
  1. Failure of the original treatment regimen 2 years ago. The patient was treated with an appropriate (and perhaps the most common) regimen for H. pylori infection 2 years ago with regards to both medications and dosages. The most likely cause of the patient’s current presentation is failure of the regimen to eradicate the organism. Failure of initial treatment of H. pylori can occur in up to 20% of patients.1 Re-infection is possible but far less likely than persistence of the original infection. A false-positive result on the gastric biopsy is also possible but is very unlikely given that gastric biopsy showing the presence of the organism is the gold standard for diagnosis of H. pylori infection.

    REFERENCES
    1. Vakil N. Primary and secondary treatment for Helicobacter pylori in the United States. Rev Gastroenterol Disord 2005;5:67–72.

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