Helicobacter%20pylori%20infection Signs and Symptoms

Signs and Symptoms

Definition

Dyspepsia

Presence of ≥1 of the following:
- Bothersome postprandial fullness
- Early satiation
- Epigastric pain
- Epigastric burning
No evidence of structural disease that is likely to explain the symptoms
Symptoms were present within the last 3 months with onset ≥6 months prior to diagnosis (Rome IV criteria)
Though the relationship between functional dyspepsia and Helicobacter pylori (H pylori) is unclear, improvement of functional dyspepsia symptoms was seen with elimination of H pylori infection

Etiology

Helicobacter pylori

A spiral-shaped Gram-negative bacterium involved in the development of gastritis, duodenal and gastric ulcers, and gastric cancer
- H pylori gastritis may decrease or increase acid secretion and cause dyspeptic symptoms
- Up to 90-95% of patients with nonsteroidal anti-inflammatory drug (NSAID)-related duodenal ulcers and 80% of patients with non-NSAID-related gastric ulcers are infected
- Adaptability in gastric conditions and production of urease allow it to colonize the stomach
Acute infection is mostly asymptomatic and is acquired through human-to-human contact via gastro-oral and fecal-oral routes
Chronic infection is strongly associated with the development of gastric epithelial and lymphoid malignancies

Updates in the Management of Gastric Cancer

Prof Yasuhiro Kodera, Prof Winnie Yeo, 23 Jul 2019

Globally, gastric cancer is the third leading cause of cancer death.¹ Its primary treatment is gastrectomy with adjuvant chemotherapy or chemoradiotherapy to improve survival. Although neoadjuvant chemotherapy or adjuvant chemoradiation is preferred in Western countries, postoperative adjuvant chemotherapy is still the mainstream therapeutic strategy in Asia.² At a recent symposium in Hong Kong, experts discussed updates in the treatment and management of gastric cancer, with a focus on the use of S-1 (TS-ONE^®; Taiho Pharma Singapore), a combination of tegafur, gimeracil, and oteracil potassium.

Apixaban may be the DOAC of choice for AF patients at risk for GI bleeding

Dr. Teo Wee Siong, 21 Jan 2023

While current guidelines recommend using direct oral anticoagulants (DOACs) over warfarin in patients with non-valvular atrial fibrillation (NVAF), there is a lack of head-to-head trial data to guide the choice of DOAC. Esteemed expert Dr Teo Wee Siong, Consultant Cardiologist & Cardiac Electrophysiologist from Mount Elizabeth Medical Centre, Singapore, reviewed the latest data on the comparative effectiveness and safety of DOACs in AF, provided valuable insights on considerations for the selection of DOACs, and shared his clinical experience with apixaban (Eliquis, Pfizer).

Relationship between tumour response to systemic therapy and overall survival in unresectable hepatocellular carcinoma

Dr Raghav Sundar, 09 Sep 2019

Overall survival (OS) is currently the primary criteria in assessing the efficacy of a cancer treatment. Dr Raghav Sundar, a consultant medical oncologist at the National University Hospital, Singapore, details the crucial role played by tumour response in evaluating treatment efficacy, with a focus on the multiple kinase inhibitor lenvatinib in the treatment of hepatocellular carcinoma (HCC).