Helicobacter pylori causes quite common infections : two-thirds of the world’s population is infected by it anytime. In most cases, it doesn’t cause ulcers, nor does it have detectable symptoms, but can only be found in tests. On the other hand, when the symptoms do appear, you can see that you have an infection with that bacteria, but it may too late for an easy treatment.
How does Helicobacter pylori affect you
For many years, it has been thought that the ulcer is caused by stress, spicy foods, smoking, or an unhealthy lifestyle, but recent studies have shown that, in fact, Helicobacter pylori bacteria is responsible for a greater number of stomach problems.
Once in the digestive system, Helicobacter pylori attacks your stomach mucosa – the one that protects your organ from gastric acid – and in time it gets “holes”, these holes being ulcers.
The bacteria can be transmitted from person to person either through feces or saliva (by kissing or eating using the same cutlery used by an infected person without cleaning them in advance).
Symptoms of Helicobacter pylori infection
The main signs of infection with this bacterium are bloating, increased need for gas removal (by eructation or flatulence) and loss of appetite. In some cases, nausea and vomiting or weight loss occur without a clear reason. Stomach pain occurs especially when eating garlic, which the bacteria is sensitive to.
In case of a preexisting ulcer, you will feel burns in the stomach or chest, especially on an empty stomach (between meals or during the night), but they pass when you eat, or when you take gastric bandages. In case of ulcer caused by Helicobacter pylori, a strict regimen should be maintained.
What tests you can do
Blood tests: Helicobacter pylori infection can be detected by blood tests. However, following the bacterial treatment, blood tests are no longer conclusive, because they can be positive even a few months after the bacteria are removed.
Stool sample: Is clearer than a blood test when it comes to Helicobacter pylori and doesn’t give the wrong results after treatment.
Endoscopy: Endoscopy is a testing method only employed in hospitals: the tube with an endcap is inserted into the patient’s stomach. After endoscopy, a sample is taken from the endoscope and a biopsy is performed.
Barium test: You have to drink a barium bottle, then your doctor makes an x-ray. Liquid covers the inside of the neck and stomach, so that ulcers or other stomach problems can be detected.
Helicobacter pylori treatment
In general, a treatment containing a complex medication scheme is prescribed to eliminate the infection. These include antibiotics, and the specialist can also prescribe adjuvants that are taken with antibiotics, medicines that reduce acidity in the stomach or vice versa, which can cause the production of more acid. Treatments are different from person to person.
Questions and answers
1. What is Helicobacter Pylori infection?
Helicobacter pylori, previously known as Campylobacter pylori, is a gram-negative, microaerophilic bacterium usually found in the stomach. It was identified in 1982 by Australian scientists Barry Marshall and Robin Warren, who found that it was present in a person with chronic gastritis and gastric ulcers, conditions not previously believed to have a microbial cause. It is also linked to the development of duodenal ulcers and stomach cancer. However, over 80% of individuals infected with the bacterium are asymptomatic, and it may play an important role in the natural stomach ecology.
The mode of transmission is oral, the infection being most commonly acquired in infancy. The path of infection in some countries may be untreated water. Helicobacter Pylori remains one of the most prevalent infections in humans, with the prevalence of infection being highly correlated with socio-economic status and ranging from 50-80%.
2. How does Helicobacter pylori infection occur?
In 50% of cases, the infection doesn’t produce symptoms. When the symptoms do occur, the patient can accuse isolated or combined pains in the upper abdomen, bloating, feeling full after ingestion of small amounts of food, nausea, vomiting or lack of appetite. In some cases, clinical manifestations may be the direct expression of complications such as gastrointestinal bleeding (expulsion of black, glossy fecal matter).
The infection is associated with numerous gastrointestinal disorders including chronic gastritis (chronic inflammation of the gastric mucosa), gastric or duodenal ulcers, and gastric neoplasias (gastric adenocarcinoma and gastric lymphoma).
The extra gastric manifestations in which Helicobacter Pylori infection has been implicated have been shown to be: anemia of unknown cause, vitamin B12 deficiency and idiopathic thrombocytopenic purpura.
3. How is Helicobacter Pylori diagnosed?
For the diagnosis of Helicobacter Pylori infection, a series of non-invasive tests are used:
- Respiratory test that measures certain substances in the expired air after ingestion of a special liquid with high diagnostic accuracy (sensitivity and specificity of over 90%)
- Antigen testing in a sample taken from feces (with accuracy similar to that of the respiratory test)
- Serological tests with anti-Helicobacter Pylori antibodies but which have low diagnostic accuracy (with many false positives or false negative results). These tests can be recommended under special conditions, such as recent antibiotics and medications that reduce gastric secretion in complicated ulcers with bleeding or malignant gastric affections.
- There are also invasive diagnostic tests for Helicobacter Pylori infection: a biopsy, and a small superficial fragment of the stomach lining, a maneuver carried out by the gastroenterologist on the occasion of superior digestive endoscopy.
4. When testing for Helicobacter Pylori infection is recommended?
Helicobacter pylori infection identification tests are indicated:
- In patients diagnosed with gastric or duodenal ulcer or history of ulcer
- In patients with dyspeptic manifestations described above
- In the case of a family history of gastric cancer in relatives of grade I
- Prior to initiating long-term treatment with aspirin or non-steroidal anti-inflammatory drugs, particularly in patients with a history of gastroduodenal ulcer
5. When is it necessary to perform superior digestive endoscopy?
The “Test and Treat” approach to Helicobacter pylori infection is appropriate in situations where the patient’s risk of having gastric cancer is low.
If the patient’s age is over 45, the treatment of Helicobacter pylori infection should be preceded by a superior digestive endoscopic evaluation.
6. How is Helicobacter Pylori treated?
Helicobacter Pylori infection therapy includes three or four drugs – medicines that reduce acidic gastric secretion and various types of antibiotics – that are given for 10-14 days.
The treatment objectives are healing the infection and curing the ulcer disease, preventing ulcer recurrences, complications related to ulcer disease, and reducing the risk of developing gastric cancer.
In order to maximize the chances of curing the infection, it is very important to adhere to the treatment, namely to follow the instructions related to the administration of the medications and to inform the treating physician about any adverse reactions occurring during the treatment.
7. What happens after treatment?
Treatment of Helicobacter Pylori infection is followed in most cases, by a test of eradication effectiveness either by respiratory test or by antigenic testing in feces carried out at least 4 weeks after the end of therapy. In most cases, anti-Helicobacter Pylori therapy is curative. In cases where tests show persistence of infection after treatment, Line II therapy may be required.