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The most likely site of H. pylori infection is in the antrum of the stomach (C), though H. pylori may also be found in other sites. H. pylori infection can result in peptic ulcer disease (PUD) due to the bacterium's ability to damage the mucus layer protecting stomach tissue and to increase the overall acidity of gastric contents. This leads to the formation of ulcers and various symptoms of peptic ulcer disease such as burning in the epigastric region. Kusters et al. evaluate the current understanding of H. pylori stating that the bacterium can cause disease ranging from chronic active gastritis to peptic ulceration. They ascribe the success of the bacterium to cytotoxin-associated gene pathogenicity island-encoded protein CagA which aids the bacteria in colonization of the gastric mucosa. Wilkins et al. discuss the relationship between H. pylori and upper GI bleeds. Upper GI bleeds are associated with NSAID drug use and the high prevalence of Helicobacter pylori infection in patients. These are the two leading causes of peptic ulcer bleeding. Figure A is an illustration of the stomach denoting the various regions. Illustration A exhibits a stain of the gastric mucosa for H.pylori. Incorrect Answers: The other labeled regions are not the most common site of H. pylori infection. Answer A: Site A is the lower esophageal sphincter. Answer B: Site B is the pyloric sphincter. Answer D: Site D is the cardia. Answer E: Site E is the fundus.
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