58-Year-Old Woman with H. pylori Infection Highlights the Importance of Follow-Up Examinations
Summary:
This case involves a 58-year-old female patient who was diagnosed with Helicobacter pylori (H. pylori) infection after undergoing a breath test. Further hospital evaluation through endoscopy and whole-genome testing of H. pylori revealed the presence of a high-virulence strain associated with gastric cancer. The patient received a 14-day treatment regimen including acid suppression, bacterial eradication, and probiotic therapy to regulate gut flora. Her abdominal pain subsided, and follow-up tests confirmed successful eradication of H. pylori. She returned for a one-month post-discharge review and remains under ongoing follow-up care.
Basic Information: Female, 58 years old
Type of Condition: Helicobacter pylori infection
Hospital Visited: The First Hospital of China Medical University
Date of Visit: June 2022
Treatment Plan: Oral medications (Omeprazole enteric-coated capsules, Amoxicillin capsules, Bifidobacterium quadruple viable tablets)
Treatment Duration: 14 days of inpatient care followed by a one-month follow-up visit
Treatment Outcome: Complete resolution of abdominal pain and successful eradication of H. pylori
1. Initial Consultation
The patient is a 58-year-old woman who had not undergone any medical checkups in the past decade. She came in for a routine examination after being diagnosed with gastric cancer and tested positive for H. pylori via a breath test. She reported a family history of stomach cancer and a personal history of hypertension. Upon physical examination, her blood pressure was recorded at 150/80 mmHg. She was alert and cooperative during the exam but appeared fatigued. Gastroscopy revealed an ulcerated lesion with elevation in the antrum of the stomach. Whole-genome analysis of H. pylori showed a highly virulent and pathogenic strain. Additionally, genetic testing identified her as a rapid metabolizer of proton pump inhibitors (PPIs). Based on these findings, she was admitted for targeted H. pylori eradication therapy.
2. Treatment Process
After discussing the diagnosis with the patient, it became clear that prompt intervention was necessary due to the aggressive nature of the H. pylori strain and the potential risk of gastric malignancy. While she initially declined surgery to remove the tumor, we initiated pharmacological treatment to eliminate the bacterial infection. A dual therapy approach was adopted using omeprazole to reduce gastric acid production and amoxicillin for bacterial eradication. Personalized dosing was determined based on her underlying health conditions and pharmacogenomic data. To prevent antibiotic-associated diarrhea, probiotics in the form of bifidobacterium quadruple viable tablets were administered before and during antibiotic treatment.
3. Treatment Outcomes
Throughout the 14-day hospital stay, the patient responded well to treatment without experiencing any adverse effects. Liver and kidney function tests remained stable throughout. Post-treatment breath testing confirmed that H. pylori had been successfully eradicated. The patient reported feeling better, with improved sleep, appetite, and normal bowel habits. Her blood pressure also improved to 130/80 mmHg, and her abdominal pain had completely resolved. She was discharged with instructions to return for a follow-up visit in one month and was strongly encouraged to proceed with surgical treatment for the gastric tumor as soon as possible.
4. Key Recommendations for Recovery
While the patient's condition improved significantly after treatment, it is crucial to remain vigilant due to the chronic and potentially recurrent nature of H. pylori infections. Additionally, the presence of untreated gastric neoplasia necessitates continued monitoring. The following recommendations were emphasized:
Avoid spicy, coarse, or sharp foods and alcohol. Opt for soft, semi-liquid, or liquid meals rich in protein to support healing and nutrition.
Rest at home and avoid strenuous activities. Monitor closely for symptoms such as black stools, vomiting blood, persistent abdominal pain, fatigue, or weight loss.
Maintain regular medical follow-ups, especially for early detection and management of any complications related to gastric cancer.
5. Clinical Insights and Patient Education
This case highlights the serious consequences of long-standing, undiagnosed H. pylori infection. The patient presented with advanced gastric pathology, including cancer and peptic ulcer disease, likely due to years of untreated infection. Her lack of preventive healthcare over the last decade contributed to this outcome. This serves as a powerful reminder that early detection and timely treatment are critical for preventing severe gastrointestinal diseases. Individuals experiencing persistent digestive discomfort should seek medical attention promptly rather than delaying care. Early intervention not only improves prognosis but also reduces long-term healthcare costs and complications.