Diagnostic tests for the presence of H. pylori can be either endoscopic or nonendo-scopic. Endoscopic diagnosis requires the extraction of gastric tissue samples that are subsequently tested for H. pylori.9 Recent antibiotic use can lead to a false negative biopsy result. Although endoscopy is the gold standard for detecting H. pylori infections, it may be associated with rare but severe complications and greater expense than nonendoscopic diagnostic methods. Endoscopy is therefore usually reserved for patients more than 50 years of age who have anemia, GI bleeding, or unexplained weight loss.

FIGURE 18-2. The arachidonic acid pathway.

Clinical Presentation and Diagnosis of PUD

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