Helicobacter pylori – chances are high that you have it or have had it

Most people infected with Helicobacter pylori do not have any symptoms. Anyone diagnosed with H. pylori should be eradicated. Eliminating H. pylori helps heal any ulcers that are present, reduces the risk of stomach bleeding, and reduces the likelihood of stomach cancer and all other complications listed below under “H. pylori-related complications.”

Approximately 66% of the world’s population is infected with Helicobacter pylori. Most are children. Helicobacter pylori has no effect on the onset, persistence, or severity of gastroesophageal reflux disease (GERD) symptoms. Often called reflux.

Adaptability of Helicobacter pylori to the gastric environment

The stomach is the storage area for digestion. Its digestive juice consists of strong acid – hydrochloric acid, enzymes – pepsin, gastric amylase and gastric lipase, water, intrinsic factor and electrolytes. The stomach prevents self-digestion by a protective layer of bicarbonate-rich mucus.

H. pylori protects itself from digestion by secreting two alkaline substances, specifically urease and ammonia, which neutralize acids in its surrounding environment. Most bacteria do not have this ability. Furthermore, after penetrating the mucus layer, H. pylori attaches itself to the gastric epithelial layer. Helicobacter pylori prefers to inhabit the lower end and least acidic area of ​​the stomach—the antrum.

Helicobacter pylori symptoms and signs

80% of people infected with Helicobacter pylori in the stomach have no symptoms. People reporting symptoms may experience:

● Pain or burning sensation below the lower end of the sternum
● This discomfort or pain may be worse when you are hungry
● Loss of appetite
● Nausea/vomiting
● Increased belching
● Abdominal bloating
● lose weight
● Melena (black, foul-smelling, tarry, sticky stool)

Detect Helicobacter pylori

The following are the tests used to detect Helicobacter pylori:

● Gastric wall biopsy. Through endoscopy, a small piece of the lining is removed from the antrum and body of the stomach.
This is the most accurate way to diagnose H. pylori. Because this method is invasive, there are certain risks. This is the most expensive and least practical method of testing.

● Stool test. This test is used to detect the presence of traces of Helicobacter pylori in the stool. This test can be used to diagnose an active infection or whether the infection has been eliminated.

● C-urea breath test. This is a highly accurate test that can detect the current presence of H. pylori infection or the success of a treatment regimen. In the test, you swallow a substance containing urea and your breath is analyzed 15 minutes later. If carbon dioxide levels increase compared to before urea was administered, this means that Helicobacter pylori is present.

● Blood tests. This test detects the presence of Helicobacter pylori antibodies. It cannot tell whether a person is currently infected with H. pylori. The test can remain positive for several years after the infection is eradicated. This test should not be used to determine whether H. pylori treatment is effective. This test has the highest percentage of false-positive results of all the tests offered. Most UK hospitals have abandoned the test.

● Footnote: All tests except blood tests require that proton pump inhibitors be stopped for 2 weeks before the test.

Transmission of Helicobacter pylori

We are not 100% sure how a person becomes infected with H. pylori, however, available evidence suggests the following are the main modes of transmission:

● Undercooked food or contaminated water.
● Human-to-human transmission – saliva, vomit/feces contact, oral (anal) sex.

Complications related to Helicobacter pylori

Approximately 90% of people infected with Helicobacter pylori remain without complications during their lifetime. Others may experience:

● Inflammation of the stomach (gastritis)
● Gastric and/or duodenal ulcers
● Stomach bleeding
● Gastric cancer – 90% of gastric cancers are caused by Helicobacter pylori
● Non-Hodgkin lymphoma
● Helicobacter pylori may play a role in the development of pancreatic cancer, AD dementia, urticaria, Parkinson’s disease, migraine, iron deficiency anemia, pernicious anemia, and immune thrombocytopenic purpura.

Treatment of Helicobacter pylori

• H. pylori is treated with a combination of two different antibiotics and a proton pump inhibitor, taken over two weeks. No treatment option is 100% effective. Bismuth may be added to some treatment regimens.
• Possible non-drug treatments include probiotics, cranberry juice, broccoli, green tea, aloe vera, olive oil, licorice, honey and curcumin.
• Research suggests that H. pylori may be spontaneously eradicated, especially in young children.

Helicobacter pylori eradication test

● Best done 28 days after completion of treatment and at least two weeks after stopping proton pump inhibitors.
● Tests that can confirm eradication include stool antigen testing, C-urea breath testing, or gastric mucosal biopsy.
● Blood tests for H.pylori antibodies are not useful in determining whether H.pylori has been eradicated.

Author: Dr. C. Malcolm Grant – Family Physician – Home Care Clinic, Arnos Vale – Former Tutor, School of Medical Sciences, University of the West Indies, Cave Hill, Barbados. Appointments: clinic@familycaresvg.com, 1(784)570-9300 (office), 1(784)455-0376 (WhatsApp)
Disclaimer: The information provided in the above article is for educational purposes only and is not a substitute for professional medical advice. If you are seeking medical advice, diagnosis, or treatment, please consult a medical professional or health care provider. Dr. C. Malcolm
Grant, Family Care Clinic or The Searchlight Newspaper or their affiliates respectively are not responsible for the risks or issues associated with using or acting upon the above information.