Mrs S.W is 60 year old unemployed female. She smokes 20 cigarettes every day a drinks over 25 units per week. Had eradication therapy for H.pylori-assosiated duodenal ulcer 12 months ago.
ndShe was asymptomatic after treatment, but 6 monthes later she had recurrence of epigastric pain.
A (C14) urea breath test was positive.
She had a haemoglobin level 14,2 g/dl and a mean cell volume 102 fl
1) What further evaluation is needed?
2) What treatment will you recommend?