In the case of a patient with abdominal pain and positive rapid urease test, what is the most appropriate treatment?

The most appropriate treatment for a patient with abdominal pain and a positive rapid urease test is to initiate therapy with omeprazole (Prilosec) alongside antibiotic treatment targeting Helicobacter pylori. This is due to the understanding that the rapid urease test is indicative of H. pylori infection, which is a common cause of peptic ulcers.

Omeprazole, a proton pump inhibitor, serves two purposes: it reduces gastric acid secretion, facilitating the healing of the ulcer, and it creates a more favorable environment for antibiotics to work effectively against H. pylori. Antibiotics such as amoxicillin, clarithromycin, or metronidazole are typically used in combination with the proton pump inhibitor to eradicate the H. pylori infection, which is crucial in treating duodenal and gastric ulcers associated with this pathogen.

Other treatment options presented do not effectively address the underlying cause of the abdominal pain indicated by the rapid urease test. Surgical interventions, like selective vagotomy and antrectomy or elective ulcer excision, may be considered in more advanced or surgical cases of peptic ulcer disease but are not first-line treatments for managing H. pylori-related conditions. Antacids alone are not sufficient, as they do not