Helicobacter Pylori – The Peptic Ulcer Bacterium
What is Helicobacter Pylori?
Helicobacter Pylori (or helicobacter or just HP) is a very common bacteria found in the stomach of two thirds of the world’s population. HP has adapted to the special conditions in the stomach hiding from the acid under the natural mucous layer of the stomach where it can live without oxygen and also neutralize any acid in the vicinity.
Although HP is probably the most common infection worldwide it was only in 1982 that HP was discovered in Australia. As the first researcher in Scandinavia H Raskov in 1985 found HP related to gastric ulcer and gastritis in Danish patients.
Who gets HP?
HP is most prevalent in the poorest parts of the world and least in the industrialized areas such as Europe and North America. It is estimated that approx. 25% of the Danish population has HP. Usually individuals become infected during childhood, perhaps shortly after birth, and HP remains in the stomach into adulthood , where it might cause problems. HP can be found in some foods like poultry and eggs, but any food can be contaminated with HP. Why HP causes problems in some individuals and not in others is unknown .
What are the problems of HP infection?
Since HP over time can destroy the normal barrier protecting the stomach mucosa from the acid , HP can result in gastritis (mucosal inflammation in the stomach) and peptic ulcers, especially in duodenum. Most people with ulcers are infected with HP .
Between 10 and 20% of all HP will subsequently develop ulcer and/or gastritis. On the other hand 80-90% of HP positive individuals wil not experience any problems. Thus many people do not know if they have HP in the stomach.
Is long-term HP infection dangerous?
The life-time risk of gastric cancer is approx. 1%. Long-term HP infection increases the risk of gastric cancer 6-8 times. On the other hand protects HP infection against cancer of the esophagus and the gastro-esophageal junction .
How do we find HP infection?
A HP infection without symptoms is almost never found as individuals usually only present themselves to their doctor with a problem.
HP can be detected in a breath test or stool sample. Both methods demonstrate HP with approx. 90 % confidence .
HP can also be detected during endoscopy (gastroscopy) with tissue sampling (biopsies) for microscopy. Endoscopy is indicated in cases of suspected ulcercancer and usually above 40 years of age.
How is HP treated?
HP infection is treated with 2 types of antibiotics together with an acid-reducing medicament for a week.
Raskovs Clinic will send you a prescription for the treatment if the results of the tests are positive for HP.
How do we know if the treatment was effective?
Four weeks after the antibiotic treatment you have to go to the lab and do a breath test. Along with the recipe, you will receive a requisition for the breath test. Once the result has been received by Raskovs Clinic you will be contacted.
What if the treatment was ot effective?
In some cases HP is resistant to the commonly used antibiotics. If this is the case (i.e. positive breath test following treatment) a new treatment with other drugs must be initiated. You will receive information from Raskovs Clinic.
What if the breath test is positive despite several treatment attempts?
If the first two standard treatments have not been effective, it may be necessary to carry out an endoscopy with bacterial samples to investigate the resistance patterns of the bacteria.
What if the bacteria can not be eradicated?
In rare cases it is not possible to eradicate the bacteria despite all treatment attempts. In these cases control endoscopies are recommende every 2 years to check for development of gastritis and ulcers. Most cases of chronic HP infection will not cause any problems.