Helicobacter pylori

SCREENING PROTECTS!

Abdominal pain? Flatulence? Nausea?
Helicobacter pylori – a bacterial infectious disease

In 1905, bacteria were observed in the stomach for the first time. However, they were ignored and almost forgotten about until there was a breakthrough in 1983 and they were recognised worldwide as a cause of gastric and duodenal ulcers.
People had previously believed that bacteria were unable to survive in the acidic gastric juice. These stomach bacteria were given the name Helicobacter pylori and, with an incidence of approximately 50%, are one of the most common causes of chronic bacterial infections in the world. A total of 370 strains of this bacterium have so far been identified. Around 33 million people in Germany are infected with this pathogen. 10 % to 20 % of carriers develop a gastric or duodenal ulcer over the course of time.

Helicobacter pylori are rod-shaped bacteria that have the ability to colonise the cells of the gastric mucosa despite the aggressive stomach acid and the thick mucus that lines the stomach. Frequently, this colonisation produces no symptoms and therefore goes unnoticed.

The exact cause of how the disease is transmitted is not yet known. It seems that the infection with these bacteria, which usually occurs in childhood, mainly happens through the mouth, via the faeces (stool), from person to person or through contaminated water or contaminated food. Developing countries where poor hygienic conditions prevail have the highest numbers of infected people.

The bacteria are able to survive for decades in the stomach. Helicobacter pylori forms the enzyme urease, which is able to covert the urea found in the stomach into ammonia. Ammonia neutralises the stomach acid, allowing the bacterium to move unhindered with its small flagella (thread-shaped movement organ in bacteria) through the mucus and nest in the gastric mucosa. The bacterium is largely able to fend off attacks by the immune system. The bacterium increases the production of stomach acid and inhibits the formation of mucus, leading to chronic gastritis. 75 % of all gastric ulcers are caused by Helicobacter pylori, along with approx. 95 % of duodenal ulcers. The chronic infection with these bacteria is also a risk factor for the development of gastric cancer.

Therapy involves a combination of different antibiotically acting tablets, meant to destroy the bacteria, and a gastric acid blocker, which reduces the production of stomach acid in order to create uncomfortable conditions in the stomach for the bacteria.
Only about 1 % of the patients have a new infection in the first year following the treatment.

A protective vaccination is not yet available. Since the transmission path is not yet fully clear, there are still no adequate preventative measures that can be carried out. Compliance with hygienic standards is recommended (your doctor will be glad to advise you on this point).

It is by no means the case that all patients infected with Helicobacter pylori will experience symptoms. As with other gastrointestinal disorders, non-specific symptoms such as belching, flatulence, bloating, increased heartburn, pressure pain in the stomach area, nausea, vomiting and diarrhoea may occur.

A Helicobacter pylori infection can be detected using various tests:

  • The diagnostic method of choice is gastroscopy This allows the doctor to view the gastric mucosa directly and also to take a tissue sample for examination under a microscope. The doctor often will perform what is called a urease quick test immediately afterwards to detect the presence of the enzyme (urease) produced by Helicobacter pylori.
  • There is also the option of taking a blood sample to prove the presence of the bacterium by testing whether antibodies against the Helicobacter pylori are present in the blood. If this test is positive, it only means that the body has had contact with the bacterium. However, positive antibodies can still be found even one year after successful therapy.

  • A stool sample can also be used for detection. The pathogen is grown and identified in a culture. This method is very suitable for use with children.
  • The easiest detection method is the Helicobacter pylori 13-C-urea breath test. Its accuracy is almost 100 %. In this test, the patient takes a „urea tablet”, which is very well tolerated. If there is an infection, the urea is split by the urease enzyme produced by the bacteria, which is dectected as „special carbon dioxide” in exhaled air. The result is available on the following day.

Your doctor will be glad to advise you with regard to other questions about diagnostics and any necessary therapy.

RECOMMENDED LABORATORY TESTS

  • Helicobacter pylori 13 C breath test
  • Detection of the Helicobacter pylori antigen in the stool
  • Determining Helicobacter pylori antibodies in the blood

Do you have any questions? We will be glad to advise you.

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