Management Of Helicobacter Pylori Infection
LINDA N. MEURER, M.D., M.P.H., DOUGLAS J. BOWER, M.D., Medical College of Wisconsin, Milwaukee, Wisconsin
Am Fam Physician. 2002 Apr 1 65:1327-1337.
Helicobacter pylori is the cause of most peptic ulcer disease and a primary risk factor for gastric cancer. Eradication of the organism results in ulcer healing and reduces the risk of ulcer recurrence and complications. Testing and treatment have no clear value in patients with documented nonulcer dyspepsia however, a test-and-treat strategy is recommended but for patients with undifferentiated dyspepsia who have not undergone endoscopy. In the office setting, initial serology testing is practical and affordable, with endoscopy reserved for use in patients with alarm symptoms for ulcer complications or cancer, or those who do not respond to treatment. Treatment involves 10- to 14-day multidrug regimens including antibiotics and acid suppressants, combined with education about avoidance of other ulcer-causing factors and the need for close follow-up. Follow-up testing is recommended for patients who do not respond to therapy or those with a history of ulcer complications or cancer.
Testing For H Pylori Infection:
There are several different ways of testing for an H Pylori infection.
1) Stool Testing: This is considered the gold standard in H Pylori diagnosis as it counts the actual particles of the H Pylori organism. This is the test I use with clients to find out if they are infected.
2) Blood Tests: These tests look for antibodies to the H Pylori organism and will test for IgA, IgG and IgM reactions. If these antibodies test positive it is a clear diagnosis of an infectious process. Research has shown that this is a good test for acute infections but long-term infections and individuals with weakened immunity often do not have elevated anti-bodies.
The other issue with H Pylori antibodies is they may be present even when the infection is under control. This means you will test positive even you are actually negative and the organisms are in their proper numbers.
3) H Pylori Breath Test: The H Pylori organism produce urease which breaks down urea in the stomach into ammonia and carbon dioxide. The breath test measures for elevated CO2 that is produced from this reaction.
4) Endoscopy: This is a highly invasive procedure where a scope is inserted into the esophagus and stomach. This is stressful on the body and does a poor job of analyzing for the presence of this infection but it can see the results of the infection such as irritation, ulcerations and cancer in the stomach.
How Is An H Pylori Infection Diagnosed In A Child
Your childs healthcare provider will take a health history and do a physical exam. The provider may also order other tests, including:
- Stool culture. This looks for any abnormal bacteria in your childs digestive tract that may cause diarrhea and other problems. A small stool sample is collected and sent to a lab.
- Breath tests. These tests check if there is any carbon present after your child drinks a special fluid. If carbon is found, that means that H. pylori is present.
- EGD or upper endoscopy. This test looks at the lining of the food pipe , the stomach, and the first part of the small intestine . It uses a thin, lighted tube or endoscope. The tube has a camera at one end. The tube is put into your childs mouth and throat. Then it goes down into the esophagus, stomach, and duodenum. Your childs provider can see the inside of these organs. A small tissue sample or biopsy is taken if needed. The tissue sample can be checked for signs of infection or of H. pylori bacteria.
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What Is Irritable Bowel Syndrome
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What is Irritable Bowel Syndrome ?
Irritable bowel syndrome is one of a spectrum of common functional gastrointestinal disorders. Symptoms of IBS can include constipation, diarrhea, alternating diarrhea and constipation, abdominal pain, urgency, bloating, straining at stools, and a sense of incomplete evacuation. The Rome III definition for IBS, which is widely accepted in the medical community, is recurrent abdominal pain or discomfort at least three days per month for at least a three month period, with at least two of the following symptoms also present: improvement of the pain or discomfort with defecation, a change in frequency of stools, and/or a change also in the form or appearance of stool.
The symptoms of IBS are usually long term, and, although they can cause daily gastrointestinal symptoms, are frequently episodic, meaning that they do not occur on a daily or regular basis. Symptoms may be triggered by specific foods or by stress but often no specific triggers can be identified
IBS is much more common in women than men and the onset of idiopathic IBS symptoms is usually in the teens or young adulthood. Symptoms of IBS can occur as a result of intestinal infection or can be precipitated by major life events.
What causes IBS?
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How Do You Treat H Pylori
If you have a confirmed case of H. pylori and experience uncomfortable symptoms, your provider can provide treatments to get rid of the infection, cure the ulcers, and reduce your risk of developing further complications.
Your provider could prescribe a combination of two antibiotics together with medication that reduces your stomach acid in order to allow the antibiotics to work most effectively.
If you have active ulcers, the team suggests that you avoid spicy foods, alcohol, and smoking as these can inhibit your healing process.
To learn more about H. pylori and treatments that can help, call the office or use the online booking tool to make an appointment today.
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H Pylori: The Silent Killer Living Inside All Of Us
This life-threatening bacteria is insidious. But why do so few people know of its existence?
Alisha, a 30-year-old sales manager, hated going out in public. She refused offers of evenings out with her friends, bypassed busy events and dreaded business meetings with a passion.
It wasnt that she disliked socialising she had always been quite gregarious at heart but chronic gastric symptoms were making her life a misery and she preferred to hide herself away.
Although her symptoms were troublesome, ranging from bloating and mild stomach pain to flatulence and belching, they didnt seem serious enough to seek medical advice. She did some research online and decided it could be aerophagia, which is caused by swallowing too much air, and tried to treat it by avoiding carbonated drinks and putting an end to her chewing gum and smoking habits. Yet nothing seemed to help.
Several months passed and Alisha was no longer just embarrassed by her symptoms, but was feeling uncomfortable throughout the entire day, while horrible abdominal cramps had started to keep her awake at night.
She arranged an appointment with Dr Denesh Gopalan, a gastroenterologist at Welcare Hospital in Dubai. He decided to test her for the little-known bacteria, H Pylori. The diagnosis was positive.
The Centers for Disease Control and Prevention in Atlanta estimates that two-thirds of the worlds population is infected with the bacterium, making it the most widespread infection in the world.
Diarrhea And Severe Symptoms After Antibiotics For H Pylori
Hi there I have been treated for hp with amoxicillin omoprozole ? And metrozidole ? Excuse the spelling I have to give another stool sample to see if cleared the bacteria but since the end of treatment I go to the toilet 3/4 times a day before it was 3/4 times a week my stomach feels gurgly and I feel empty.
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How You Get H Pylori
As I stated earlier, H. pylori is a common bacteria found in many people around the world and most commonly it is passed from person to person.
H. pylori can be passed from person to person by saliva but it can also be passed from contaminated food or water.
Some other examples of how it can be passed:
- eating from the same utensils
- eating foods that were contaminated by a persons unwashed hands
The most common route? Acquiring H. pylori from your mother in infancy .
If you didnt get it from your mother, then catching it from someone else in your adult years is quite possible. The likelihood of infection is equal to a persons age .
Heres the bad news: H. pylori can take root when youre under immense stress.
When youre under stress, this reduces your immune functioning, which makes it hard for your body to fight off H. pylori when it enters your digestive system.
Even more proof that theres a strong connection between your mind and gut!
If your immune functioning is poor, H. pylori will easily take hold and make a home in your stomach.
What does an H. Pylori infection feel like? Lets cover that next.
Hpylori Causes Vitamin B12 Malabsorption
A likable little green Cheeto? Not so much! h.pylori causes vitamin B12 malabsorption and diarrhea. By attaching to the stomach lining h.pylori blocks parietal cells from making intrinsic factor and stomach acid.
At first glance it might seem as if that could make h.pylori an antacid of the first order, a living, breathing antacid that could save you tons of money on antacids. The truth, however, is that without enough stomach acid your digestion and your nutrition suffer.
Not only that, h.pylori is a leading cause of peptic ulcers leading to stomach cancer.
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Fgids Autoimmune Diseases And Atopy
In two large studies of UK primary care patients, an association with autoimmune diseases and atopy was examined. A significantly higher prevalence of autoimmune disorders, particularly rheumatological autoimmune disorders, was more frequent in those with FD, constipation and multiple FGIDs . This association was not explained by differences in age or gender. In this same group, atopic conditions were also found in excess among all FGID groups considered when compared with controls . This association may be explained by a shared genetic susceptibility, or common disruption of the microbiome and similar immunological disorders in these conditions . A study from the USA showed similar findings, in that adults with atopic symptoms report a high prevalence of IBS, suggesting a link between atopy and IBS . In a study of endoscopy all-comers in London, UK, duodenal eosinophilia was significantly commoner in patients with a history of allergy , and patients with PDS were significantly more likely to report a history of allergy than those without upper gastrointestinal tract symptoms , also supporting an important link between allergy and FGIDs . Whether symptoms of FGIDs wax and wane with the severity of these associated conditions is yet to be determined.
H Pylori And Long Term Health Problems
H Pylori disrupts the digestive process so it can lead to inflammation throughout the gut and gastrointestinal permeability. This state of leaky gut can also cause iron-deficient anemia, irritable bowel symptoms with fluctuating diarrhea and constipation and ulcerative colitis.
Since gut health is intimately related to brain health, an H Pylori infection can lead to depression, anxiety and trouble concentrating . Altered digestion also increases food sensitivities and autoimmune reactions. This can lead to any number of autoimmune conditions that are so prevalent in our society today.
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Organism Shedding In Stool
Regardless of stool consistency, H. pylori was not isolated in any of the stool samples collected. EPEC was recovered in the stool of 12/19 H. pylori-infected versus 21/26 H. pylori-uninfected subjects . Those with no EPEC shedding did not differ in baseline characteristics from the rest of the participants.
EPEC was shed as early as 4 h after ingestion. Median time to EPEC shedding was longer for H. pylori-infected than for H. pylori-uninfected subjects: 42.4 h compared with 23.2 h, respectively, although this difference did not reach statistical significance . EPEC shedding was not associated with stool consistency , but participants with loose stools shed EPEC faster than those with no loose stools, with median time of 18 versus 32.2 h, respectively . At the end of antibiotic treatment, all subjects had negative EPEC stool cultures five subjects developed detectable EPEC IgG antibodies 1 month after challenge.
Metronidazol Did The Trick
At the end of March, 2005, things changed. The homeless doctor prescribed 17 days of Metronidazol: 500 mg every 6 hours. I saw the homeless doctor because the privy pit destroyed my financial stability and caused my home to be foreclosed. I got my home back via bankruptcy and selling my rental. .
After 17 days of Metronidazol I still had symptoms, so the doctor prescribed the same again. That did the trick.
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Signs + Symptoms Of H Pylori
One of the first tell tale signs of an H. Pylori infection is the display of upper GI symptoms.
If you suffer from stomach pain, reflux, heartburn, excessive belching, or a feeling like food is sitting in your stomach, then youll want to take note.
Other symptoms could include:
- tar colored stools, indicating a bleeding ulcer
Adaptation To The Stomach
To avoid the acidic environment of the interior of the stomach ” rel=”nofollow”> lumen), H. pylori uses its flagella to burrow into the mucus lining of the stomach to reach the epithelial cells underneath, where it is less acidic.H. pylori is able to sense the pH gradient in the mucus and move towards the less acidic region . This also keeps the bacteria from being swept away into the lumen with the bacteria’s mucus environment, which is constantly moving from its site of creation at the epithelium to its dissolution at the lumen interface.
H. pylori is found in the mucus, on the inner surface of the epithelium, and occasionally inside the epithelial cells themselves. It adheres to the epithelial cells by producing adhesins, which bind to lipids and carbohydrates in the epithelial cell membrane. One such adhesin, BabA, binds to the Lewis b antigen displayed on the surface of stomach epithelial cells.H. pylori adherence via BabA is acid sensitive and can be fully reversed by decreased pH. It has been proposed that BabA’s acid responsiveness enables adherence while also allowing an effective escape from unfavorable environment at pH that is harmful to the organism. Another such adhesin, SabA, binds to increased levels of sialyl-Lewis x antigen expressed on gastric mucosa.
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How Are H Pylori Infections Treated
If you have an H. pylori infection that isnt causing you any problems and you arent at increased risk of stomach cancer, treatment may not offer any benefits.
Stomach cancer, along with duodenal and stomach ulcers, is associated with H. pylori infection. If you have close relatives with stomach cancer or a problem such as a stomach or duodenal ulcer, your doctor may want you to have treatment. Treatment can cure an ulcer, and it may reduce your risk of developing stomach cancer.
Additional Tests For B
If blood tests reveal a vitamin deficiency, your doctor may perform other tests to determine the type and cause, such as:
- Antibodies test. Your doctor may draw a sample of your blood to check for antibodies to intrinsic factor. Their presence indicates pernicious anemia.
- Methylmalonic acid test. You may undergo a blood test to measure the presence of a substance called methylmalonic acid. The level of this substance is higher in people with vitamin B-12 deficiency.
- Schilling test. In this test, you first ingest a tiny amount of radioactive vitamin B-12. Then your blood is checked to see if your body absorbed the vitamin B-12. After that, you ingest a combination of radioactive vitamin B-12 and intrinsic factor. If the radioactive B-12 is absorbed only when taken with intrinsic factor, it confirms that you lack your own intrinsic factor.
Watch for these signs and symptoms:
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How Does H Pylori Affect Your Throat Doctor Explains
Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.
The link between H. pylori, acid reflux, laryngopharyngeal reflux, and throat infection is controversial.
The role of H. pylori in throat symptoms is still unclear.
No definitive link was found between H. pylori and GERD which is often responsible for throat symptoms.
Some small studies detected H. pylori bacteria in the throat and the upper part of the esophagus.
Today, we will discuss the link between H. pylori and throat symptoms such as sore throat, globus sensation, mucus in the throat, and cough.
Does H Pylori Cause Gerd
Gastroesophageal reflux disease or chronic acid reflux occurs when your stomach acid refluxes back up to the esophagus. Eventually, the acid may reach your throat and cause symptoms such as:
- Chronic reflux cough.
- Pain in the throat .
- Globus sensation in the throat.
- Mucus in the throat.
- Water brush .
- Chronic inflammation of the larynx .
H. Pylori doesnt seem to cause GERD. According to studies, H. pylori doesnt affect the lower esophageal sphincter . The incompetence of the LES is responsible for acid reflux.
Moreover, H. pylori doesnt seem to affect the esophagus motility.
However, The only way that h. pylori can affect GERD is probably by altering the acid inside the stomach.
For example, eradication of H. pylori in a subset of patients may improve GERD symptoms .
If H. pylori gastritis involves the main body , Treatment of H. pylori may WORSEN the symptoms of GERD.
In conclusion, the link between GERD and H. pylori is weak, no evidence suggests that H. pylori is the main cause of throat symptoms with GERD.
Other explanations on how H. pylori can affect your throat are discussed below.
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The Damaging Effects Of H Pylori Infections:
H pylori is an opportunistic bacterium that can infect and spread rapidly in individuals with a compromised immune system . While this bacterium is natural and beneficial to our bodies in small amounts, it can be extremely dangerous when allowed to propagate without control. This infection is the leading cause of stomach ulcers, poor digestion and stomach cancer .
It is estimated that over 50% of the worlds population has elevated levels of H Pylori . This microorganism can spread very quickly through the saliva and so it is easily transmitted. It is very common to see entire familys test positive for this infection. Immune compromised individuals can develop this through sharing a drink, kissing and eating off the same dishes as an infected individual.