Helicobacter pylori (H. pylori) is a spiral-shaped bacterium that grows well in the acidic environment of the gut. It affects half the population of the world!
Since its discovery in 1982 by Drs. Barry Marshall and Robin Warren (who won the Nobel prize for it), it has been linked to a number of stomach problems, including peptic ulcer disease (acidity-related problem), which is the most common.
This article gives an overview of H. pylori, how it causes peptic ulcer disease, what other problems it can cause, and how it is currently treated, and how it can be prevented. This information is meant to help patients understand their disease and how to treat it better.
What Is Helicobacter pylori?
Helicobacter pylori is a bacterium that can survive the acidic environment of the stomach, thanks to its unique characteristics.
It has a helical shape that allows it to penetrate the stomach’s mucous lining, where it is protected from stomach acid. The bacterium also produces an enzyme called urease, which neutralizes stomach acid in its immediate environment, further enhancing its survival.
Transmission
Helicobacter pylori (H. pylori) is primarily transmitted from person to person through the oral-oral and fecal-oral routes.
Oral-oral transmission: This route involves the spread of the bacterium through saliva. Sharing utensils, toothbrushes, or other personal items can facilitate the transmission of H. pylori from an infected person to an uninfected individual. Close personal contact, such as kissing, may also contribute to the spread of the bacterium.
Fecal-oral transmission: In this route, the bacterium is transmitted when an individual ingests food or water contaminated with fecal matter containing H. pylori. Contamination can occur due to poor hygiene practices, inadequate sanitation, or improper handling of food and water.
Environmental transmission, though less common, has also been suggested. In this case, H. pylori could be acquired from contaminated water sources, soil, or unhygienic environments.
How Does H. pylori Cause Peptic Ulcer Disease?
Peptic ulcer disease encompasses both gastric (stomach) and duodenal (upper part of the small intestine) ulcers. These ulcers are open sores that form when the protective mucus layer of the stomach or duodenum is compromised, allowing stomach acid to damage the underlying tissue.
H. pylori is responsible for approximately 90% of ulcers in the duodenum (first part of the small intestine) and 80% of stomach ulcers.
The bacterium’s damaging effects stem from several factors:
a. Weakening the protective mucous layer: H. pylori damages the cells responsible for producing the protective mucus, leaving the stomach lining vulnerable to the corrosive action of stomach acid.
b. Inflammation: The presence of H. pylori triggers an immune response that leads to inflammation of the stomach lining (gastritis). Chronic inflammation increases the risk of ulcers.
c. Production of toxins: Some strains of H. pylori produce toxins that can damage stomach and duodenal cells, further increasing the risk of ulcer formation.
Other Complications Associated with H. pylori
Besides peptic ulcer disease, Helicobacter pylori have been linked to several other gastric disorders and complications.
a. Gastric cancer
H. pylori infection is a significant risk factor for the development of gastric cancer. The chronic inflammation caused by the bacterium can lead to changes in the stomach lining, eventually resulting in cancerous growth.
Researchers have found that people who have H. pylori are six times more likely to get stomach cancer than people who don’t have it.
b. Gastritis
As mentioned earlier, H. pylori can cause gastritis, an inflammation of the stomach lining. Gastritis can manifest as pain or discomfort in the upper abdomen, nausea, and vomiting.
c. MALT lymphoma
H. pylori has also been implicated in a specific type of stomach cancer called MALT (mucosa-associated lymphoid tissue) lymphoma. MALT lymphomas are rare and often associated with long-standing H. pylori infections.
Studies show that H. pylori have been found in more than 75% of people with mucosa-associated lymphoid tissue (MALT) cancer.
Treating and Preventing H. pylori Infection
Diagnosis
Several tests can detect the presence of H. pylori, including breath tests, blood tests, stool tests, and endoscopic biopsies. Your doctor will determine the most suitable test based on your symptoms and medical history.
Most patients who have constant acidity-related symptoms will be advised to undergo an upper gastrointestinal endoscopy. A rapid urease test is conducted to see if bacteria are present.
Treatment
The primary treatment for Helicobacter pylori infection is a combination of antibiotics and acid-suppressing medications called proton pump inhibitors (PPIs).
This therapy, known as triple therapy, typically lasts for 14 days. Following this, an antacid (usually a proton pump inhibitor) is given for a period of 4 to 8 weeks.
In some cases, quadruple therapy, which includes the addition of a bismuth-containing compound, may be prescribed to enhance treatment effectiveness, especially in regions where antibiotic resistance is prevalent.
It is crucial to follow your doctor’s instructions and complete the full course of treatment to ensure the elimination of H. pylori and prevent the development of antibiotic resistance.
After treatment, a follow-up test may be performed to confirm the bacterium’s eradication.
Prevention
While there is no assured way to prevent H. pylori infection, certain measures can reduce your risk. I have previously spoken about how you can use simple lifestyle measures to prevent acidity.
Practice good hygiene
Wash your hands frequently and thoroughly with soap and water, especially before preparing or consuming food and after using the restroom.
Drink clean water
Use clean, treated water for drinking and cooking. Avoid drinking water from potentially contaminated sources.
Consume well-prepared food
Ensure that the food you consume is properly washed, cooked, and stored to minimize the risk of H. pylori contamination.
Avoid sharing utensils and personal items
Do not share utensils, toothbrushes, or other personal items, as H. pylori can be transmitted through saliva.
Conclusion
Helicobacter pylori is a pervasive bacterium responsible for a majority of peptic ulcer cases and various other gastric complications.
By understanding its role in the development of these conditions, patients can be better equipped to recognize symptoms and seek appropriate treatment.
Early diagnosis and intervention are crucial for preventing further complications associated with H. pylori infection. Treatment typically involves a combination of antibiotics and acid-suppressing medications to eliminate the bacterium and promote healing.
Adopting preventive measures, such as maintaining good hygiene and consuming safe food and water, can help reduce the risk of H. pylori infection. By staying informed and working closely with medical professionals, patients can effectively manage and prevent H. pylori-related disorders, ensuring a healthier and more comfortable life.
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