Do you know that your body has more than 200 species of bacteria living in it? Well, some of these bacteria are harmless and actually protect the body. On the other hand, some pose quite significant health risks. Helicobacter pylori (H. pylori) are one of these bacteria that can survive in the stomach, only to cause health problems in the long run.
What is H. pylori?
- Pylori infection of the stomach is the most common cause of peptic ulcers (sores of the lining of the stomach). It can cause gastritis (inflammation of the stomach lining) and stomach cancer as well.
- Pylori bacteria are found worldwide, and they affect more than 50% of the global population. In the developing countries, the figures are even higher – up to 50% of children and 80% of adults are likely to be infected. Although the bacteria are widespread, most people do not even realise that they are affected since most of the infections are usually silent, with no symptoms. Nevertheless, the H. Pylori is usually active in the stomach lining, destroying the protective coating and causing inflammation.
How is it spread?
- Pylori is primarily thought to be spread from one person to another by saliva, fecal contamination of food or water. Drinking untreated water, crowded conditions, poor hygiene and improper food handling are therefore the significant contributors to this worldwide prevalence of H. pylori infection.
When you consume the bacteria, it moves to the stomach and upper small intestines, where it burrows into the stomach lining. Most people become infected when they are children, and the progression of the infection takes decades. As the bacteria continue to invade the protective stomach coating, it allows hydrochloric acid to destroy the lining, causing open sores (ulcers).
What are the signs and symptoms?
If symptoms are present, they are usually due to peptic ulcers (commonly known as stomach ulcers) or gastritis. Peptic ulcers are characterised by dull or burning stomach pain just below the ribs and above the belly button, bloating, nausea, loss of appetite, frequent burping and unintentional weight loss. The pain is aggravated by an empty stomach and gets better after eating, drinking milk or taking an antacid. Gastritis pains share a lot of these features but tend to be less localised (it is more generalised).
How is a Helicobacter infection diagnosed?
Among the tests and procedures that your doctor may order if H. Pylori infection is suspected include:
During the test, you will provide the doctor with two breath samples into separate bags, one before and one 30 minutes after a carbon-enriched urea pill is taken. Presence of H. pylori will convert this urea pill into carbon dioxide which is absorbed and breathed out throughout the lungs. The two samples are then analysed to tell the level of carbon. If the levels of carbon rise, it suggests the presence of H. pylori.
The breath test requires optimal preparation, in order to get accurate results. You will need to:
- Fast for about 4 to 6 hours before the test
- Avoid protein pump inhibitor antacids for at least two weeks
- Wait for about 4 weeks after antibiotic treatment or oral bismuth subsalicylate preparations
Relies on the detection of IgG antibodies specific to H. Pylori. Unfortunately, certain factors limit the usefulness of the antibody test. First, the antibodies remain in the body long after the infection has been eradicated. It therefore does not tell whether the infection is active or not. Secondly, the test cannot be used to determine whether the infection has been eliminated or not.
The breath test has consistently been ranked as one of the best methods to detect H. pylori infection. The American Society for Gastrointestinal Endoscopy recommends the use of the urea breath test when endoscopy is not indicated. It is non-invasive, fast, and has over 95% accuracy. A breath test can tell if the infection is active and also, it can reliably indicate if antibiotics have eradicated the infection or not.
Other tests that may be used include
- Stool test– detect the presence of H. Pylori proteins (antigen) in stool. Usually reserved for use in children.
- Culture and sensitivity– involves growing of H. pylori in special media, after a biopsy is taken during endoscopy.
- Rapid urease testing– detects urease, an enzyme released by H. pylori
How is it treated?
If you already have peptic ulcers, the treatment of choice is a combination of antibiotics and acid-lowering medications. Due to H. pylori’s ability to develop resistance to antibiotics, doctors usually give a combination of at least two antibiotics to eradicate the infection. The antacids neutralize or block the production of stomach acids to help the stomach lining heal.
In addition to the drug combination, another way to soothe the pain is by following a regular meal schedule. Focus on eating five to six small portions but regular meals, so that the stomach does not remain empty for long. It is also prudent to consult your doctor if you would like to take medications like aspirin, non-steroidal anti-inflammatory drugs (NSAIDS) as they irritate the stomach lining and worsen the ulcers.
If you suffer from H. pylori infection with gastritis or ulcer, avoid at all costs spicy, fatty and acidic foods. Certain foods may worsen your symptoms, known as stomach irritants:
- Certain beverages (milk, chocolate milk, caffeine, hot cocoa and cola, even decaf, peppermint and spearmint tea, alcohol and acidic juices)
- Spices and seasonings (pepper, chilli powder, mustard seed)
- Other (chocolate, dairy)
Eat a variety of healthy foods from all the food groups. Eat fruits, vegetables, whole grains, and fat-free or low-fat dairy foods. Whole grains include whole-wheat bread, cereals, pasta, and brown rice. Choose lean meats, poultry (chicken and turkey), fish, beans, eggs, and nuts. A healthy meal plan is low in unhealthy fats, salt, and added sugar. Healthy fats include olive oil and canola oil.
Stop eating two hours before bedtime.
After one full course of treatment, a biomarker test is necessary for confirming that the infection is gone. As mentioned before, the best method is the urea breath test. Remember that lack of compliance to medication dosage and plan is one of the major causes for treatment failure and development of resistance to antibiotic. It is imperative that for any therapy for H. pylori eradication (or any other treatment for that matter), you should follow the strict dosage and length of course instructions from your doctor.
Is it preventable?
Unfortunately, there is no vaccine available for H. pylori. Since it is proven that the bacteria is spread through poor hygiene and food handling practices, the best ways to prevent it include;
- Proper handwashing after using the bathroom, before eating and after handling waste
- Eating properly cooked food
- Drinking clean and safe water
Pylori is a strain of bacteria that we may be able to stop spreading by adopting healthy hygiene practices, early detection, and treatment. Although these are simple interventions, they mean the difference between a healthy stomach and severe complications such as cancer. Take note!
If you’re interested in learning more about Helicobacter pylori infection and how it can harm your body, read on more about it in our biomarker post here!
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