Gastroenterology - Helicobacter Pylori

What is Helicobacter Pylori?

Helicobacter Pylori (H Pylori) is a form of bacteria, a bug or germ. It lives in the sticky fluid (mucous) which coats the lining of the stomach and duodenum. It is usually a life long infection and in most cases causes no problems. However, it is often associated with peptic ulcer.

What is a peptic ulcer?

Peptic ulcers look like mouth ulcers. They are sensitive raw patches in the lining of the stomach or duodenum (the part of the gut immediately after the stomach). There are two kinds of peptic ulcer; gastric and duodenal. Gastric ulcers are ulcers in the stomach, and duodenal ulcers are those of the duodenum.  Research has shown that H Pylori is an important cause of peptic ulcers.

Where does H Pylori come from? How do we get infected?

H Pylori are a germ that can only infect human beings. It is still not certain how this germ moves from the stomach of one person to the next. Data indicates that most people get the bacteria in early childhood. However, some people get the bacteria in later life. Good hygiene in the home seems to lower the risk.

What does H Pylori do?

H Pylori acts as an irritant to the lining of the stomach, which causes inflammation of the stomach (gastritis). H Pylori also appear to be important in the development of peptic ulcerations. A combination of factors may contribute to causing ulcers of the stomach or duodenum. These include H Pylori, gastric acid, genetic background, use of aspirin or drugs for arthritis and cigarette smoking. Removing the H Pylori infection can give a permanent cure for most gastric and duodenal ulcers (with the exception for some people taking Aspirin and arthritic drugs).

How can H Pylori infection be detected?

When you are infected with H Pylori, you will produce antibodies to fight against these bacteria. It is possible to detect these antibodies by having a blood test.

Another procedure is to have an Endoscopy. This is a procedure in which a flexible camera is passed into the stomach so that the lining can be seen. A sample (biopsy) of your stomach lining is then taken to detect the bacteria.

Establishing the presence or absence of H Pylori may be determined by using a ‘faecal antigen test’. To do this you will be provided with a container to place a small stool sample in.

The laboratory may then test the stool sample for evidence of H Pylori. This is a very sensitive test and will tell us whether or not H Pylori is still in your stomach. This test has now replaced the blood test which was not as useful as this newer test as it could not tell whether or not H Pylori had been successfully eradicated, whereas this new test can.

Taking PPI (Proton Pump Inhibitor) medication such as Losec or Lansoprazole can interfere with all of these tests.

How can a person get rid of H Pylori infection?

Removing bacteria from the stomach can be very difficult. However, H Pylori usually responds well to certain antibiotics. 90% of H Pylori infections can be removed if the course of treatment is completed. Sometimes a second course of treatment with different antibiotics is needed and even then the treatment may be unsuccessful.

Most treatments for H Pylori involve taking 3 types of drugs, usually for 7 days. They consist of two antibiotics and a drug to stop acid production by the stomach. This helps the antibiotics to work more effectively. The treatment may cause side effects, including abnormal taste, nausea or mild diarrhoea. Alcohol should be avoided when taking some of the medication.