HELICOBACTER PYLORI

Helicobacter Pylori 


Humans' stomachs are susceptible to infection by the gram-negative spiral flagellate known as Helicobacter pylori, or H. Pylori. This bacterium was first identified in 1982 and has been reported to be associated with cancers of the mucosa of the stomach, esophagus, colon and rectum. especially the type of cancers associated with the lymphoid tissue of the stomach mucosa known as diffuse large B cell lymphoma and stomach adenocarcinoma. H. pylori might be located in the stomach's antrum  with out any clinical symptoms. Other times in immune- compromised individuals can cause sever inflammations even ulcers in the lining wall of the stomach. Certain enzymes and toxins produced by the bacterium can damage stomach and duodenum tissues as it causes production of the urease enzyme and affects the stomach's protective lining. Your stomach acids are neutralised (made less acidic) by this enzyme. Your stomach's lining becomes more fragile as a result. Acids and potent digestive fluids will therefore pose a larger threat to the health of stomach cells. Your stomach and duodenum may develop ulcers as a result.

 Both stomach and duodenum, which makes up the initial part of the small intestine, are open to invasion. This could cause redness and inflammation. Peptic ulcers, which are unpleasant lesions in the upper digestive tract, can also develop in sever cases Sadly, infection by H. Pylori is very common worldwide. Recently, it was reported that more than 50% of the population are infected by this bacterium, many of them showed no any clinical signs (has no symptoms), others showed sever clinical signs of  stomach and duodenal inflammations, ulcers even cancers, this being more common in the developing countries as a result of  bad hygienic conditions, higher infection rates and poor sanitation .

What are the main causes of H. pylori?

When H. pylori bacteria invade your stomach, H. pylori infection results. The most common way for H. pylori bacterium to spread from one person to another is by direct contact with saliva, vomit, or feces. Infection in developing countries is more common due to poor sanitation conditions and bad hygiene. Contaminated food or water can spread H. pylori infection. so, it was suggested that good hygienic conditions could decrease rate of infection by the H.pylori bacterium.

    Symptoms:

Infected individuals with H. pylori make up to 90% who never show any signs of illness or consequences. Why many people don't exhibit symptoms is still unknown. However, When H. pylori infection is present,the risk of getting peptic ulcers can reach 20% and the following signs are frequently appeared in case of acute infection 

-Diffuse epigastric pain made worse by consuming more meals.

-Passage of black stool from rectum.

-Constipation associated with bleeding in some cases.

-Non cancerous tissue growth projecting from  the mucous membrane of the stomach, colon and rectum known as polyps can be developed. these polyps could cause constipation. colorectal bleeding, anemia. also gastric polyps could cause dyspepsia, acid reflux and heart pain.

- Stomach ache that could get worse while you're hungry

-Nausea

-Impaired appetite

-A lot of burping

-Bloating

-Anemia  as a result of  stomach bleeding.

-losing weight& fatigue.

In chronic infection by H.pylori bacterium, the risk of developing gastric, esophageal, colon and rectal cancers increases. In addition to the developed ulcers in different portions in the digestive tract.

 If you have an ulcer, you may feel dull or burning pain in your stomach. It may come and go, but you’ll probably feel it most when your stomach is empty. It can last for a few minutes or for hours. You may feel better after you eat yoghurt , drink milk, or take  frequent small meals in order to buffer high acidity and take before an antacid.

 N.B. if you notice any signs and symptoms of the following Immediately seek the medical help :

  • Severe abdominal pain that may awaken  from sleep
  • Bloody or black tarry stools
  • Bloody or black vomit 

  Complications of H. Pylori:

Helicobacter pylori infection for an extended period of time may result in adenocarcinoma and B-cell lymphoma, as well as asymptomatic chronic gastritis, chronic dyspepsia, duodenal ulcer disease, gastric ulcer disease, or other gastric malignancies.

 Major risks for infection:

1. being in a close restricted place. Your chance of getting the infection by H. pylori can raise.

2. being without a clean source of water make the risk of infection by H. pylori increased. In other hand, presence of  consistent supply of clean, flowing water prevents transmission of infection.

3. H. pylori infection is more frequent in those who reside in developing countries as a result of the congested and unclean living conditions which are are more common in developing countries

4. If you share a residence with someone who has H. pylori, your chance of getting the bacterium is increased.

  Diagnosis of H. Pylori :

  • Several methods of testing H. pylori bacterium can be used like the invasive and non- invasive methods.

  • The non- invasive methods are including the antibody blood test, stool test while the invasive methods are including the endoscopic biopsy

  • Antibody blood tests. Can check presence of antibodies that indicates you have the bacterium. 

  • Stool culture. A small stool sample is collected and sent to a lab. In 2 or 3 days, the test will show if you have any abnormal bacteria.

  • Endoscopic biopsy. That looks at the lining of your esophagus, stomach, and duodenum and can see the inside of these organs. A small tissue sample (biopsy) is taken for further examination. The tissue sample can show if you have the urease enzyme and the bacteria.

  • For accurate diagnosis of H. pylori infection histological examination can be done after the endoscopic biopsy accompanied with the bacterium culture.

   Prevention & Treatment:

   1. Prevention:

  • Avoid contacting persons who have H. pylori infection and avoid sharing their food and drinks.
  • Avoid using  tools of  other infected person.
  • Use clean water for cleaning  and washing, wash your hands after using toilets.
  • Through the use of antibiotic-based medication regimens, the bacterium has been eradicated in numerous studies in an effort to stop the onset of disorders linked to Helicobacter pylori. 

    2. Treatment:

  • First-line treatment is advised to include a proton pump inhibitor or antacids like H2 blockers, bismuth, doxycycline, and nitroimidazole for 10–14 days.
  •  Levofloxacin has been recommended as part of the treatment for strains of H. pylori that are resistant to clarithromycin.
  • Encourage milk and yogurt in diet.
  • Avoid spices and fried food.
  • Stop smoking, alcohols, coffee and tea as it increases stomach acids 
  • Avoid stress because it increases HCL production.
  • Avoid ulcerogenic drugs as NSAIDs (non steroidal anti inflammatory drugs as brufen and aspirin)
  • Make a frequent small meals regime in order to buffer high stomach acidity.
  • Finally, rest and sedation improve healing in case of ulcers and also relief pain.

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