Helicobacter Pylori










About Helicobacter Pylori



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Helicobacter pylori is a bacterium that causes inflammation of the stomach lining (gastritis) and peptic ulcers. This bacterium is recognized as the most common cause of gastritis in the world. It is estimated that half of the world’s population is infected with H. pylori bacteria and that it is responsible for 75% of stomach ulcers and about 90% of duodenal ulcers. Interestingly, most people with H. pylori never develop ulcers or any other gastrointestinal disease.

In addition to being a major cause of peptic ulcers, specifically duodenals, helicobacter pylori has been linked with many other conditions, such as: gastric cancer, lymphocytic gastritis, protein losing gastropathy, ischaemic heart disease, and impaired growth in childhood.

As we mentioned above, about 50% of the world’s population is infected with the helicobacter pylori bacteria. These infections are most often acquired in early childhood. Individuals in a higher socioeconomic bracket appear to have a lower rate of occurrence of the H. pylori bacteria while communities with indigent and immigrant populations seem to have higher rates. Since the late 1960s, there has been an approximate 50% decline in the number of individuals contracting H. pylori infections in North America. Conversely, in developing countries, approximately 70% of children are infected by the time they reach ten years of age and infection rates generally vary between 70 and 90%.



How it's Spread



As is usually the case with bacteria, poor sanitary conditions will spread helicobacter pylori more readily. This is probably why there is a higher infection rate in developing countries, as opposed to the decreasing rate in North America. The H. pylori bacteria can be spread through feces, therefore unsanitary conditions or improper hand washing can lead to spreading the bacteria from person to person.

Contaminated water can also spread the H. pylori bacteria. In many countries where there is an inadequate waste removal system, the water system used for drinking and cooking can become contaminated. Some illnesses can spread the bacteria as well. For example, individuals who suffer from gastroesophageal reflux disease can spread the bacteria when they experience an acid reflux or belch. This action causes the H. pylori germs to rise from the stomach and into the throat and mouth where it can be transmitted to other individuals.

Some studies have also been performed in order to test the theory that H. pylori bacteria can be spread through insects. Some of the research indicates that there might be a relationship between insects and H. pylori, but it is too early to make a definitive conclusion. Additional research may shed light on this important issue.



The Stomach Cancer Connection



Once studies proved that helicobacter pylori caused stomach ulcers, researchers began to look at the bacteria as a cause of stomach cancer. Research conducted in the early 1990s showed that people infected with H. pylori were three to six times more likely to develop stomach cancer. This research is not conclusive proof of a causal relationship, but it is compelling. Contrary to the above research findings, in some developing countries where the rates of H. pylori infections are in the 90% range, the occurrence of stomach cancer in in these populations is equal or less than the national average in North America. Even so, the research on helicobacter pylori is significant enough that the World Health Organization (WHO) in 1994 declared H. pylori a class-1 carcinogen (the rating reserved for the most significant cancer-causing agents).






Diagnosis



The majority of people infected with helicobacter pylori are never diagnosed with an ulcer and therefore, are never tested for H. pylori. Physicians will normally perform the test on individuals over the age of 50 who have had a history of peptic ulcer disease, or on those individuals with a family history of ulcers or stomach cancer.

There are three types of tests that are used to determine the presence of the helicobacter pylori: endoscopy, biopsy, and noninvasive. With endoscopy, a patient is lightly sedated and a fiber-optic tube with a camera on the end is lowered into the throat, down to the stomach and the duodenum. During this test, doctors can take pictures and remove tissue samples to later analyze for the H. pylori. Biopsies are performed on the tissue samples collected to test for the presence of the bacteria. Different types of tests can be performed on the samples including a rapid urease test (RUT), H. pylori culture, histologic assessment, and polymerase chain reaction (PCR) assay. Noninvasive tests can also be performed although they are not as accurate as endoscopy and biopsy. Types of noninvasive tests include: urea breath, serological (antibody), finger prick blood test, stool antigen immunoassay, and saliva.



Treatment



There are several antibiotics which have been successfully used for treating helicobacter pylori infections. Physicians usually treat this infection by prescribing two antibiotics concurrently, as they are attempting to permanently eradicate the bacteria. In addition to antibiotic treatment, doctors will also prescribe medication that serves to reduce stomach acid in an attempt to reduce the inflammation that is so common with this type of infection. Permanent eradication of the H. pylori infection is determined when there is an absence of the infection for more than four weeks after the final treatment with medication.

There is some question as to the validity of a true cure for helicobacter pylori infections. The reason being that in the West, a small percentage of cases seem to reoccur, while reoccurrence has been as high as 9% in developing countries. Whether this is due to a failure of the treatment or whether the H. pylori bacteria has been contracted once again (e.g., a different strain, etc.) the research has not yet been completed and a clear conclusion is therefore not available.



Conclusion



The Helicobacter Pylori bacteria is a major cause of peptic ulcer disease and can cause stomach cancer. The main preventative measure for dealing with the H. pylori bacteria is proper sanitary practices, such as proper hand washing in order to minimize contamination. H. pylori has been successfully treated through the use of antibiotics and the concurrent use of medication which minimizes stomach acid. The World Health Organization has designated H. pylori as a class 1 carcinogen; a significant cancer causing agent.

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