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Helicobacter Pylori
This unusual name identifies a specific bacteria that can cause infection
of the stomach. This infection can contribute to the development of diseases,
such as dyspepsia (heartburn, bloating, nausea), gastritis
(inflammation of the stomach), and ulcers in the stomach and duodenum.
It will be useful to know some things about the upper digestive tract to
understand how and where Helicobacter pylori infection can occur.
When food is swallowed, it passes through the esophagus (the tube that connects the throat to the stomach). It then enters the larger upper part of the stomach. A strong acid that helps to break down the food is secreted in the stomach. The narrower, lower part of the stomach is called the antrum. The antrum contracts frequently an vigorously, grinding up the food and squirting it into the small intestine. The duodenum is the first part of the small intestine, just beyond the stomach. The stomach, including the antrum, is covered by a layer of mucous that protects it from the strong stomach acid. It is known that alcohol, aspirin, and arthritis drugs such as ibuprofen can disrupt the protective mucous layer. This allows the strong stomach acid to injure underlying stomach cells. . In some people, corticosteriods, smoking, and stress appear to contribute in some way. Until the mid 1980's it was felt that one or more of these factors working together led to the development of gastritis and ulcers. Since that time, evidence has been mounting that Helicobacter pylori (H. pylori) has a major role in causing these diseases. The Infection
H. pylori is a fragile bacteria that has found an ideal home in the
protective mucous layer of the stomach. These bacteria have long
threads protruding from them that attach to the underlying stomach cells.
The mucous layer that protects the stomach cells from acid also protects
H. pylori. These bacteria do not actually invade the stomach cells as
certain other bacteria can. The infection, however, is very real and
it does cause the body to react. Infection-fighting white blood cells
move into the area, and the body even develops H. pylori antibodies in the blood.
H. pylori infection occurs when an individual swallows the bacteria in food, fluid, or perhaps form contaminated utensils. H-Pylori is one of the most common infection worldwide. The rate of infection increases with age, but it also occurs frequently in young people in developing countries due to poor sanitation and overcrowding condition. In many cases, H-pylori infection does not produce any symptoms In other words, the infection can occur without the person knowing it. The infection remains localized to the gastric area, and probably persists unless specific treatment is given. How is Helicobacter Pylori Infection Diagnosed?
There are currently three ways to diagnose H. pylori infection.
Gastritis and Dyspepsia
The symptoms are discomfort, bloating, nausea and perhaps vomiting.
The person may also have symptoms that suggest ulcers--burning or pain
in the upper abdomen, usually occurring about an hour or so after meals
or even during the night. The symptoms are often relieved temporarily
by antacids, milk, or medications that reduce stomach acidity. Yet,
the physician does not find an ulcer when the patient is tested by x-ray
or endoscopy. When H. pylori is found in the stomach, it is tempting to
believe that it is the cause of the symptoms, although this connection
is not yet clear. The physician will prescribe antibiotic therapy to see
if clearing the infection relieves the symptoms.
Ulcers
Stomach Cancer and Lymphoma
These two types of cancer are now known to be related to H. pylori bacteria.
This does not mean that all people with H. pylori infection will develop
cancer; in fact very few do. However, it is likely that if the infection
is present for a long time, perhaps from childhood, these cancers may
then develop. This is another reason why it is important to treat H.
pylori infection.
When is Treatment Necessary?
Since the infection is so common, it is sometimes recommended that no
treatment be given when there are no symptoms. However, these
recommendations may change as more research develops. Increasingly,
physicians are treating the acute ulcer with acid-reducing medicines
and treating the infection with antibiotics. Interestingly, one of
these antibiotics is a bismuth compound that is available
over-the-counter as Pepto-Bismol. It is also available as a
generic drug called bismuth subalicylate. The bismuth part of
the medicine actually kills the bacteria. However, do not go to
the drugstore and purchase a bottle of Pepto-Bismol, expecting
this alone to cure the infection. H. pylori is buried deep in
the stomach mucous, so it is difficult to get rid of this
infection. Several antibiotic drugs are always used together
to prevent the bacteria from developing resistance to any one
of them. Current medical studies are being done to develop easier
treatment programs for this difficult infection.
Summary
H. pylori is a very common infection of the stomach. It may be
the most common infection in the world. It is now clear that
the infection is directly related to the development of stomach
and duodenal ulcers, and it is likely that it may be related to
cancers involving the stomach. There are several diagnostic tests
available, and effective treatment can prevent the recurrence of
ulcers and perhaps the development of cancer.
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