What is helicobacter pylori bacteria (H Pylori)
It is a rod like bacteria with tentacles.
It has been proven already that the H. Pylori causes more than 90% of duodenal ulcers and 80% of gastric ulcers.
When the bacteria enters our body, it attaches itself onto the walls of our gut and produces a toxin that causes inflammation. If it is not treated, prolonged inflammation may eventually result in ulcers and cancer formation.
What are the symptoms of gastritis and ulcer disease?
- abdominal bloatedness and nausea
- burping and belching
- abdominal pain
- heart burn
- bad breath
- loss of appetite and in severe cases even loss of weight.
In fact, an estimated 50% of adults in the world today has H.Pylori infection. Higher if you are in developing countries and Lower if you are in an industrialised , developed country.
When the gastritis and ulcer disease are severe , they may even lead to bleeding from the walls of the stomach and intestines , resulting In you feeling
- fatigue and having fainting spells
- anaemia or low blood count
- black foul smelling tarry stools
- in severe cases even hemorrhage which may be fatal.
- In the long run - it can even lead to gastric cancer.
Some other known causes of Gastritis and ulcer disease includes :
- smoking and drinking
- regular use of pain medications called non-steroidal anti-inflammatory drugs ( NSAIDS ) which includes aspirin and ibuprofen.
How does H Pylori spread
Its still not known how H. Pylori spreads. Researchers suspect it may be spread via unclean food and water or through contact with an infected person’s saliva and other body fluids.
Risk factors to getting it includes overcrowding and poor sanitation or habitation conditions.
Therefore good hand washing and drinking clean water are some of the ways to prevent a H.Pylori infection.
Evidence has also shown that adults age 50-60 and above tends to have a higher prevalence of H.Pylori within their gut .
H Pylori tests
Anyone with symptoms of gastritis and ulcer disease should get themselves checked for H.Pylori.
- Gastric endoscopy
Most accurate test. A small camera will be passed through the mouth and oesophagus into the stomach and small intestine. Through this tube, a small sample of the stomach wall lining where the inflammation is seen can be collected and sent for biopsies and CLO testing.
The advantage of this test is that a visual confirmation of gastritis or ulcer disease can be confirmed and gastric cancers can also be excluded.
- Urea breath test.
This is a simple non invasive test where you are required to blow into a bag before and after swallowing a pill to see if the carbon dioxide level rises in the second bag where you breathe into.
An increase in carbon dioxide would indicate a H.Pylori infection. This is a good test to be done in children whom a H.Pylori infection is suspected.
- Blood testing for H.Pylori antibodies
- Stool testing for H.Pylori antigen or a H.Pylori culture to attempt to grow the bacteria from the stool sample
H Pylori treatment
The good news is that there are effective treatment to eradicate H.Pylori infection. It involves using a combination of gastric acid reduction medications with antibiotics (triple therapy or quadruple therapy)
However , there are cases of antibiotics resistant H.Pylori infection and also cases of re-infection following eradication of the bacteria. Hence follow ups are often necessary to ensure treatment success.
By : Dr Chen Yiming
Family Physician, MBBS (Singapore), GDFM (NUS), GDFP Dermatology (NUS)