For last week’s practice question, we quizzed participants on treating H. pylori. 78.42% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question

Question: JR is 50, has type two diabetes, and was referred to G.I. due to six months of stomach pain, intestinal, bloating, and generalized G.I. discomfort. Since they were due for their colonoscopy, the doctor also ordered an upper endoscopy to biopsy the esophagus, stomach and duodenum for any abnormalities.

The biopsy revealed that JR had moderate chronic gastritis and an H. pylori infection. JR wants to learn more about H. pylori infection. 

Which of the following statements are accurate?

Answer Choices:

1. Since H. pylori is found in about half the population, it is a normal finding, and there is no need for treatment.
2. Treatment includes double antibiotic therapy and a medication to decrease gastric acidity.
3. The preferred treatment is the consumption of prebiotics and probiotics to increase bacterial diversity.
4. Most people with H. pylori infection experience stomach cancer within the next 20 years.

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Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is incorrect. 5.27% chose this answer. “Since H. pylori is found in about half the population, it is a normal finding, and there is no need for treatment.” It is true that 50% of people worldwide house H. plyori in their stomach. However, in a small percentage of human hosts, this little bacteria “goes rogue” and causes gastritis, loss of stomach mucous lining, peptic ulcers and can be associated with some stomach cancers.

Answer 2 is correct. 78.42% of you chose this answer. “Treatment includes double antibiotic therapy and a medication to decrease gastric acidity.” YES, GREAT JOB. According to the Cleveland Clinic, 2 antibiotics and a proton pump inhibitor are prescribed to address H. pylori infections.

Antibiotics: Among the common choices are amoxicillin, clarithromycin (Biaxin®), metronidazole (Flagyl®) and tetracycline.
Proton pump inhibitor: Commonly used proton pump inhibitors include lansoprazole (Prevacid®), omeprazole (Prilosec®), pantoprazole (Protonix®), rabeprazole (Aciphex®) or esomeprazole (Nexium®).

Answer 3 is incorrect. About 13.84% of respondents chose this. “The preferred treatment is the consumption of prebiotics and probiotics to increase bacterial diversity.” Consuming prebiotics and probiotics are a recommended adjunctive therapy to antibiotics and a proton pump inhibitor. However, current evidence does not support pre and probiotics as the only treatment.

Finally, Answer 4 is incorrect. 2.47% chose this answer.” Most people with H. pylori infection experience stomach cancer within the next 20 years.” There is a slightly increased risk (~5%) of stomach cancer for those with H. plyori infection, especially if the H. pylori isn’t treated or if there is a family history of stomach cancer. This answer is suspicious because of the extreme statement that “Most” people get cancer from this bacteria gone rogue.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

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Want to learn more about the GI System and Diabetes?

From the Gut to the Butt – Exploring the GI System FREE Webinar

Now Recorded & Ready to Watch

Coach Bev invites you to join this 60 minute webinar that covers gastrointestinal health from top to bottom. Topics include; fatty liver disease diagnosis and treatment, intestinal complications associated with diabetes, keeping the microbiome healthy, and more. Join us to explore the magnificent wonders of diabetes and the gut.

Getting to the Gut Topics:

• From the Mouth to Intestines: Periodontal disease, Gastroparesis, Fatty liver disease, pancreas disorders
• Intestine as an Endocrine Organ & Bacterial Host
• NASH Treatment Options including lifestyle and pharmacotherapy
• State the relationship between gut health, microbiome and diabetes and inflammation
• Describe 3 strategies to get our microbiome back to better health.

Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast

Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.

All hours earned count toward your CDCES Accreditation Information

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Diabetes and the Gut – ADCES Hawaii Annual Conference with Coach Beverly

October 27, 2023 – Join us in beautiful Oahu & Earn 6.5 CEs

Conference Schedule

Location: Honolulu Country Club, 1689 Ala Pu’umalu Street, Honolulu, HI

CEs: 6.5 CEs for physicians, nurses, pharmacists, physician assistants, dieticians & social workers.

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The use of DES products does not guarantee the successful passage of the diabetes certification exams. CBDCE & ADCES does not endorse any preparatory or review materials for the certification exams, except for those published by CBDCE & ADCES.