What are some potential indications for the

What are some potential indications for the long term use of acid-suppressive therapy (proton pump inhibitors) and given the above potential adverse events, what would your discussion entail for a patient, who through mutual decision making, is considering long term therapy with a PPI? H. pylori infection causes gastritis, PUD, gastric cancer and mucosa-associated lymphoid tissue (MALT) lymphoma. Approximately 20% of infected individuals will develop PUD and less than 1% will develop gastric cancer. HP eradication markedly decreases ulcer recurrence. Assuming your patient tests positive for this organism, describe your therapeutic plan including possible medication options, patient and drug related factors used to make your selection, duration of therapy, monitoring, patient education and any potental follow up such as labs, testing or continued use for PPIs.

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