Inclusion Criteria And Exclusion Criteria
Inclusion criteria were as follows:
- Study population including patients with IBS regardless of diagnostic methods
- Studies which evaluated H. pylori infection among study populations regardless of detection methods
- Study design: cross-sectional studies, case-control studies and cohort studies.
Exclusion criteria are as follows:
- In vitro studies
- Abstracts, review articles, letters, and case reports
- Studies in which the subjects were children.
Why I Chose To Write About Hpylori
Ive wanted to write a blog post about H.pylori for quite some time now because, over the years, I have received so many enquiries from people who suffer with typical IBS symptoms of trapped painful gas, uncomfortable bloating and irregular bowel movements.
You may ask yourself, what has H.pylori got to do with IBS?
Well, the answer is quite a lot actually. When I delve a bit deeper into a patients history, it transpires that many of them were diagnosed with H. pylori and were given a prescription from their GP for eradication therapy. This consists of two antibiotics and a powerful antacid, sometimes called a proton pump inhibitor .
Eradication therapy is pretty effective at killing the H.pylori, although it is important to have a stool test after the antibiotics and antacid to ensure that the H.pylori bug is dead because if it isnt, then it may be necessary to have another round of the antibiotics and PPI.
However, what must be borne in mind is the fact that antibiotics will not only be extremely effective at nuking the H.pylori bugs, but also your friendly gut bugs. Thats the very bugs that help to properly digest your food, absorb nutrients, manufacture crucial vitamins and hormones including serotonin to help prevent depression as well as help crowd out pathogenic strains of bacteria, fungi and yeasts. In turn, this ensures you have a well-functioning immune system and reduces your risk of bowel infections and bowel cancer.
How Do You Treat Post
There are many effective, FDA-approved drugs and therapies available for post-infectious IBS , and its best to work with your healthcare provider to discuss your treatment options based on the complete picture of your health.
A recent review in Digestive Diseases and Sciences examined treatment options specifically for post-infectious IBS and drew the following conclusions:
Fecal Transplants: Current data show that fecal transplants are not effective in treating IBS.
A current review in Digestive Diseases and Sciences provides an excellent overview of how gastroenteritis can lead to IBS and discusses various treatment options for post-infectious IBS. Read Microbiome and Its Role in Irritable Bowel Syndrome.
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What Favours The In Vitro And In Vivo Colonization Of H Pylori In A Hostile Gastric Environment
H. pylori can penetrate deep into the gastric mucosal layer with its 2 to 6 polar flagella and also through the production of urease , which allows it to encounter a more friendly environment. The ammonia produced from urea hydrolysis then acts as a receptor for H+ ions and generates a neutral pH in the intracellular environment. Members of the H. pylori outer membrane proteins family of outer membrane proteins align with other H. pylori adhesion proteins and assist in the successful binding of the bacterium to the gastric epithelium . Bacterial phase variation by gene conversions and slipped strand mispairings enable H. pylori to form new subpopulations and adopt properties that allow for the neutralisation of effective human immune responses. In addition, a variety of virulence factors including babA2, horB, homB, iceA2, cagA, and dupA ensure that H. pylori persists in humans . Although not all of the functions of these factors are completely understood, available data have shown that these genes, most of which are pro-inflammatory, have the capacity to alter the physiology and morphology of gastric epithelial cells .
How To Address Your Digestive Issues In The Right Order
When a patient comes to me with a diagnosis of IBS or IBS like symptoms, from my personal experience, ~75% of the time we find H. pylori present in their stool test results.
Thats quite staggering.
This gives us answers though. We have a targeted approach and know what to tackle, and in what order.
As a general rule of thumb, addressing an H. pylori infection is the first step to achieving digestive relief.
Many times over, Ive seen patients improve drastically when we address an H. pylori infection .
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When To Consider H Pylori Testing
Helicobacter pylori, better known as h pylori, is a bacteria. Its behind most peptic ulcers, and it can cause all kinds of digestive tract issues. At Batash Medical in Rego Park, NY, we offer h pylori testing so you can take charge of your health and get the answers you need when youre suffering from digestive and abdominal disorders.
The Influence Of Gastrointestinal Infection On Brain
Taken together, we summarize the possible inflammatory and immune activation in gastrointestinal mucosa of patients with post-infectious IBS-FD in Figure.
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Treating Infections In The Right Order
If your stool test or GI Map reveals that other infections are present along with h. pylori, the best practice is to address h. pylori first. You always want to deal with the root cause first.
Because the stomach-acid lowering effects of h. pylori can cause other infections, the root cause needs to be addressed first. Then the overgrowths will be easier to clear.
H. pylori could be the reason some people struggle to clear stubborn SIBO or candida overgrowths.
How Is H Pylori Treated
If you dont have symptoms, you dont need to be treated. If you’ve been diagnosed with H. pylori, avoid taking nonsteroidal anti-inflammatory drugs. These drugs can increase your risk of developing an ulcer.
H. pylori-caused ulcers are treated with a combination of antibiotics and an acid-reducing proton pump inhibitor.
- Antibiotics: Usually two antibiotics are prescribed. Among the common choices are amoxicillin, clarithromycin , metronidazole and tetracycline.
- Proton pump inhibitor: Commonly used proton pump inhibitors include lansoprazole , omeprazole , pantoprazole , rabeprazole or esomeprazole .
- Bismuth subsalicylate: Sometimes this drug is added to the antibiotics plus proton pump inhibitor combinations mentioned above. This drug protects the stomach lining.
Combination treatment is usually taken for 14 days.
One newer medication, Talicia®, combines two antibiotics with a proton pump inhibitor into a single capsule.
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What Are The Complications Of H Pylori
If you are infected with the bacteria you can get a painful sore called a peptic ulcer. These sores form in your upper digestive tract.
A very bad ulcer can wear away your stomach lining. It can also cause problems such as:
Bleeding when a blood vessel is worn away
A hole or perforation in your stomach wall
Blockage when the ulcer is in a spot that blocks food from leaving your stomach
H. pylori can also lead to stomach cancer.
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A Better Way: Attack Sibo In Three Phases
Approach SIBO as you would any imbalance in your gut, like leaky gut or candida overgrowth.
1. Starve the bad guys and feed the good guys
First, you want to stop feeding harmful bacteria so they stop getting busy and taking over. You can read more on balancing your gut bacteria. For now, follow these main SIBO diet tenets:
2. Clear the harmful bacteria
Doctors prescribe antibiotics to clear the bacteria associated with SIBO. Research shows that herbal antimicrobials treat SIBO just as well as rifaximin, the most common antibiotic given for SIBO. Although natural herbal antimicrobials are much gentler on your system than prescription antibiotics are, youre still killing off some of the good with the bad. Which leads to
3. Rebuild your microbiome
Any time you make a change to your diet, your lifestyle, or even your sleep patterns, your microbiome adjusts. If you revamped your diet and attacked the harmful bacteria in your gut, your microbiome is most certainly out of whack for a while until it settles.
At this phase, the key is to encourage it to settle into the balance that will make you feel the best. You want just enough of each beneficial strain, and you want to keep the harmful strains in check. You can nudge it towards a balance that favors you with high-quality probiotics prebiotics , and a nutrient-dense, SIBO-friendly diet that includes enough vegetables to stuff a cow.
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What Are The Symptoms Of H Pylori
Most people have the bacteria for years without knowing it because they dont have any symptoms. Experts dont know why.
You may have redness and swelling in your stomach lining. This is called gastritis.
You may get sores or peptic ulcers in your stomach or the first part of your small intestine . Ulcer symptoms may include belly or abdominal pain, which can:
Be a dull pain that doesnt go away
Happen 2 to 3 hours after you eat
Come and go for several days or weeks
Happen in the middle of the night when your stomach is empty
Go away when you eat or take medicines that reduce your stomach acid level
Other symptoms of an ulcer may include:
The symptoms of ulcers may look like other health problems. Always see your healthcare provider to be sure.
Small Intestinal Bacterial Overgrowth
In IBS and FD patients without gastrointestinal infection history, the continuous low-grade inflammation of the intestinal mucosa may also be related to small intestinal bacterial overgrowth , since intestinal flora makes significant difference in mucosal and systemic immune response. In recent years, SIBO is considered to be significantly associated with functional bowel disease, especially IBS.76 A recent meta-analysis showed that the incidence of SIBO in IBS patients is 36.7% and it was closely associated with intestinal inflammation.77,78 There are few studies focusing on the relationship between SIBO and FD. In a small sample Brazilian study, SIBO was found in 56.5% of patients with FD but not observed in healthy controls .79 Japanese scholars tested SIBO in 38 patients with refractory functional gastrointestinal diseases and 2 patients were positive . The symptoms of 2 patients with positive SIBO were significantly improved and their breath hydrogen levels decreased to normal following levofloxacin administration for 7 days, suggesting that the occurrence of FD symptoms may be related to SIBO.80
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Symptoms Of H Pyloriwithout Stomach Problems
Why would anyone suspect the Helicobacter pylori bacteria, a bacteria that infects the stomach if they have no stomach problems?On the surface it doesnt seem to make any sense, but it will begin to make perfect sense to you in a few moments. The Helicobacter pylori bacteria, more commonly called H pylori, is a very common bacteria that is found in the stomach lining of up to 50% of the worlds population. It was first discovered by testing gastric ulcers. Findings showed that it was almost nearly always present when ulcers were there. And it wasnt just coincidence, this bacteria is the CAUSE of many stomach ulcers, but it also contributes to chronic health problems.
Interestingly, H pylori is FREQUENTLY found in the stomachs of people who do not have ulcers! But H pylori infection, IS an INFECTION and this infection causes inflammation in the lining of the stomach. Sometimes to a great degree, sometimes to a lesser degree. It’s this inflammation which causes any number of symptoms, or no symptoms at all! Generally none of which are consistent from person to person.
The most common symptoms of H pylori infection are fatigue, weight gain, depression, and chronic illness. If those symptoms sound familiar, its probably because they are the same symptoms of Gluten Sensitivity as well as being the same symptoms that approximately 50-65% of all Americans complain of on a daily basis! Coincidental? I dont think so.
Can H Pylori Infections Be Prevented
Theres no vaccine against H. pylori. But taking these steps can protect your family from many illnesses and help lower their risk of an H. pylori infection:
- Wash hands well and often, especially after using the bathroom and before making or eating food.
- Avoid food if youre not sure that it was prepared safely.
- Drink water from a safe source.
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What Is H Pylori Infection
Helicobacter pylori is a type of bacteria that can be found in a large percentage of the world’s population. Rates of infection are higher in developing countries, with the lowest rates of infection existing in industrialized nations like the United States were rates can drop to as low as 20-30%. Even in industrialized countries, infection rates are still higher among Hispanics, people of African descent, and among the elderly regardless of ethnic background. No matter where you are, lack of access to clean water and a reliable sewage system are recognized as risk factors resulting in infection.
H.pylori bacterial infections damage to tissues in the lining in your stomach and part of the small intestine known as the duodenum. H. pylori infections of the stomach are the most common cause of gastritis and peptic ulcer disease, though there can be other reasons for these conditions.
Helicobacter pylori bacteria burrow into the lining of your stomach, causing the stomach and small intestine to become chronically inflamed. This inflammation is caused by your body continuing to produce stomach acid whether or not there if food present to be digested. Normally, your stomach only produces acid in response to hormones associated with digestion. This allows the acid to help dissolve food, but not harm the lining of the stomach itself. When acid is present between meals, the extra acid eventually wears away at the mucosal lining of the stomach.
When To See A Gp
If you have indigestion and stomach pain, you can try treating this yourself with changes to your diet and lifestyle, or with medicines you can get from a pharmacy, such as antacids.
See a GP if:
- you have indigestion symptoms lasting a week or longer, or it’s causing you severe pain or discomfort
- you think it’s brought on by medicine you have been prescribed
Stomach ache and abdominal pain are not always a sign of gastritis.
The pain could be caused by a wide range of other things, from trapped wind to irritable bowel syndrome .
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Possible Mechanism Of Infection In Overlap Syndrome Of Irritable Bowel Syndrome And Functional Dyspepsia
Although meta-analysis does not support a specific association between IBS and H. pylori infection,63 some evidences suggest that H. pylori infection may be involved in the pathogenesis of IBS. The positive rate of H. pylori , cytotoxin-associated gene A, and vacuolating cytotoxin A alleles in patients with IBS-D were significantly higher than those in healthy controls.64 Both vacuolating cytotoxin A and neutrophil-activating protein significantly activated MCs and increased the release of pro-inflammatory cytokines such as IL-6.65,66 A cross-sectional, observational study has concluded that duodenal lymphocytosis was significantly associated with bloating of FD patients, and the simultaneous presence of duodenal lymphocytosis and H. pylori infection was significantly more prevalent in FD patients than in control subjects.67 In multivariate analysis, the odds of experiencing severe symptoms in patients with severe microscopic duodenitis was 2.2 times greater than in individuals with very mild, mild, or moderate duodenitis.68 A large population study showed that H. pylori infection and any dyspepsia-related consultation significantly increased the likelihood of an IBS related consultation.69 Duodenal inflammation caused by H. pylori infection may play a role in the pathogenesis of patients with IBS-FD, which needs to be confirmed in the future with more studies in patients with IBS-FD.
Can You Get A Sibo Test
Testing is tricky because short of surgery, the small intestine is hard to reach. Endoscopy only reaches the upper segment, and colonoscopy only reaches into the lower segment. That leaves over 15 feet of small intestine that you cant access with a camera or for sampling.
Another problem lies in the available tests themselves. No test perfectly indicates the presence or absence of SIBO, and theres no accepted standard among the medical community yet. So theres a lot of subjective interpretation behind the scenes that combines test results with clinical symptoms.
Heres what doctors have to work with so far.
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Gastric Ulcer Causing Diarrhea
While the instances of a gastric ulcer causing diarrhea are few and far between, they do occur in a few individuals, most notably those suffering from Zollinger-Ellison syndrome or ZES. ZES is in fact one of the least common causes of ulcers, although one of the key symptoms is diarrhea. Ifdiarrhea symptoms do appear, there may be a tumor in the pancreas and the duodenum. These tumors are known as gastrinomas, and they cause the production of excessive gastric levels. It is important to note that such tumors are often cancerous, so patients who notice that their gastric ulcer is causing diarrhea should seek diagnosis and treatment immediately. As part of the treatment, your doctor may prescribe anti acid medications in order to prevent the ulcers from recurring.
It is estimated that only 1 person in a million gets ZES each year. The figure is even lower in the category of ulcer sufferers, with only 0.1% to 1% ulcer patients being diagnosed with the condition. ZES generally occurs in people 45 to 50 years old, with men being more prone to the condition than women.
Patients suffering from ZES are also a lot more likely to develop Gastro-esophageal reflux disease or GERD, and the effects of this condition may be more severe than in patients that do not have ZES. GERD itself may cause a number of complications aside from ulcers, including a narrowing of the esophagus.
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