Helicobacter Pylori- The Silent Epidemic

Date: 04/05/2023

What is H. Pylori?

Helicobacter pylori (H. pylori) is a gram-negative bacterium usually found in the stomach, which has infected almost 80% of the Indian population. The vast majority of people infected with H. pylori have no symptoms and will never develop any problem. However, H. pylori are capable of causing several digestive ailments which include ulcers and less commonly, stomach cancer. It is not clear why some people with H. pylori get these ailments and others don’t.

How can you get infected?

  1. pylori infection is mainly acquired in childhood. The mode of transmission of H. pylori remains poorly understood. The bacteria are most commonly spread by consuming food or water contaminated with faecal matter. H. pylori can cause changes to the stomach and duodenum (the first part of the small intestine). In developing countries, a combination of untreated water, crowded conditions and poor hygiene contribute to a higher H. pylori infection rate.

What are the diseases caused by H. Pylori infection?

Not all H. pylori infections lead to the development of ulcers and stomach cancer.

However, most people infected do develop gastritis. Unless eradicated, H. pylori will remain in the stomach and will continue to cause chronic inflammation and weakening the protective force of the mucous membrane of the stomach. This will result in creating a condition whereby it is vulnerable to attack by stress, salty meals and carcinogenic substances.

1. Indigestion (Dyspepsia) –

Most people with indigestion or dyspepsia feel pain and discomfort in the stomach or chest. The sensation generally occurs soon after consuming some food or a drink. It may make a person feel full or uncomfortable during a meal, even if they have not eaten a large amount of food.

2. Gastritis –

Gastritis is an inflammation and irritation of the lining of the stomach. It can occur suddenly (acute) or gradually (chronic).

3. Ulceration –

Stomach ulcers, which are also known as gastric ulcers, are painful sores in the stomach lining. Stomach ulcers occur when the thick layer of mucus that protects your stomach from digestive juices, is reduced. This allows the digestive acids to eat away at the tissues that line the stomach, causing an ulcer.

Stomach cancer –

The causes of stomach cancer are thought to be smoking, poor eating habits and genetics. However, the latest research indicates that H. pylori eradication therapy decreases the risk of developing stomach cancer.

What are the symptoms of H. Pylori infection?

Most individuals with chronic gastritis have no symptoms. However, some people develop more serious problems, including stomach or duodenal ulcers. Ulcers can cause a variety of symptoms or no symptoms at all, with the most common symptoms including:

Certain medications can also cause peptic ulcers.  

Who should be tested for H. Pylori infection?

If you have symptoms – Diagnostic testing for H. pylori infection is recommended if you have active gastric or duodenal ulcers or if you have a history of ulcers.

There are several ways to diagnose H. pylori. The most commonly used tests include the following:

  1. Breath tests

     – Breath tests (known as urea breath tests) require that you drink a specialized solution containing a substance that is broken down by the H. pylori bacterium. The broken-down products can be detected in your breath.

  2. Stool tests

     – Tests are available that detect H. pylori proteins in the stool.

  3. Blood tests

     – Blood tests can detect specific antibodies (proteins) that the body’s immune system develops, in response to the H. pylori bacterium.

How is H. Pylori infection treated?

The treatment of H. pylori includes several steps. A two-week therapy of multiple antibiotics along with an antacid (mostly the proton pump inhibitors class of drug) is generally prescribed. After completing the H. pylori treatment, repeat testing is usually performed to ensure that the infection has been treated properly. However, there are increasing numbers of patients with H. pylori infection, who are showing resistance to the antibiotics. Hence, it is important to take the entire course of all medications as prescribed by your health care professional. The drawback though is that up to 50 percent of patients report side effects while taking this H. pylori treatment. These side effects include metallic taste, headache, nausea, vomiting, stomach cramps etc. Furthermore, patients don’t comply with the treatment as multiple dosing of several tablets per day is required, for at least two weeks.

Newer therapies for H. Pylori eradication –

There are numerous types of probiotics such as Lactobacillus species which are used for the eradication of H pylori and to prevent gastrointestinal infections. Research has shown that a unique strain of Lactobacillus reuteri (DSM17648) exerts its action by attaching to/co-aggregating with the H. pylori bacteria and flushing them out of the body. This strain of L reuteri i.e. DSM17648 is also capable of reducing the H. pylori bacterial load and side effects associated with antibiotic therapy.