H Pylori

Helicobacter Pylori

Helicobacter pylori (H. pylori is a bacterium that causes chronic inflammation (infection) in the
stomach and duodenum, and is a common contagious cause of ulcers worldwide. These bacteria are sometimes termed ulcer bacteria.

What are the symptoms?

Although many infected individuals have no symptoms, other infected individuals may have occasional episodes of belching, bloating, nausea and vomiting and abdominal discomfort 

More serious infections cause symptoms of abdominal pain, nausea and vomiting, fatigue, anaemia, decreased appetite, diarrhoea, heartburn, and bad breath.

This bacterium also is considered a common cause of ulcers worldwide; as many as 90% of people with ulcers are infected with H. pylori. However, many people have these organisms residing in (colonizing) their stomach and upper digestive tract and have few or no symptoms

H. pylori is contagious; however, some individuals may simply have the bacteria in their gut, and the bacteria causes no symptoms of disease.

Why does it happen?

H. pylori infections start with a person acquiring the bacterium from another person (via either the faecal-oral or oral-oral route). Although the majority of individuals that have these bacteria in their GI tracts have few if any symptoms, most people develop stomach inflammation (gastritis).

Other investigators have shown that these bacteria and their products cause alterations in the cells lining the stomach that when altered are associated with stomach cancers, although these are infrequently seen diseases.

How is H. Pylori diagnosed?

Accurate and simple tests for the detection of H. pylori infection are available (H. pylori infection tests). They include blood antibody tests, urea breath tests, stool antigen tests, and endoscopic biopsies.

Blood Tests: Blood tests for the presence of antibodies to H. pylori can be performed easily and rapidly. However, blood antibodies can persist for years after complete eradication of H. pylori with antibiotics. Therefore, blood antibody tests may be good for diagnosing infection, but they are not good for determining if antibiotics have successfully eradicated the
bacterium

Urea Breath Test: The urea breath test (UBT) is a safe, easy, and accurate test for the presence of H. pylori in the stomach. The breath test relies on the ability of H. pylori to break down the naturally occurring chemical, urea, into carbon dioxide which is absorbed from the stomach and eliminated from the body in the breath. Endoscopy is an accurate test for diagnosing H. pylori as well as the inflammation and ulcers that it causes. Biopsies also may be cultured in the bacteriology laboratory for the presence of H. pylori in case of failure of empiric therapy.

Stool Sample: A recently developed test for H. pylori is a test in which the presence of the bacterium can be diagnosed from a sample of stool. The test uses an antibody to H. pylori to determine if H. pylori antigen is present in the stool

How is H. Pylori treated?

 

In general, patients should be treated if they are infected with H. pylori and have ulcers. Moreover, patients who develop MALT lymphoma (a type of cancer) of the stomach have the lymphoma progress if H. pylori is not treated and eradicated. Patients should also be treated in case of a positive family history for gastric cancer. H. pylori infection is known to cause atrophic gastritis (chronic inflammation of the stomach leading to atrophy of the inner lining of the stomach). Some physicians believe that atrophic gastritis can lead to cell changes (intestinal metaplasia) that can be precursors to stomach cancer. Studies have also shown that eradication of H. pylori may reverse atrophic gastritis. Thus, some doctors are recommending treatment of ulcer- and symptom-free patients infected with H. pylori. Many physicians believe that dyspepsia (non- ulcer symptoms associated with meals) may be associated with infection with H. pylori. Although it is not clear if H. pylori causes the dyspepsia, many physicians will test patients with dyspepsia for infection with H. pylori and treat them if infection is present.