How bacteria damages the stomach
H. pylori secretes the enzyme urease, which creates a protective cloud of alkali around the microbe and hides under a layer of mucus. The bacterium attaches to mucosal cells and releases toxins, and the immune system responds with chronic inflammation. Over time, this leads to a disruption of the protective properties of the mucous membrane and a change in acid production. Some people develop a duodenal ulcer, while others develop atrophic gastritis, which can gradually develop into precancerous changes.
- Chronic active gastritis
- Peptic ulcer of the stomach and duodenum
- Atrophy and intestinal metaplasia of the mucosa
- MALT lymphoma and stomach cancer
- Unexplained iron deficiency anemia
How is the infection transmitted?
The main route is from person to person: through saliva, shared utensils, when feeding a child from an adult’s spoon, as well as through water and food contaminated with feces. Most often acquired during childhood, the infection lasts a lifetime if left untreated. Re-infection in adults after successful eradication is rare.
- Close contact with infected family members
- Shared dishes and toothbrushes
- Insufficient hand hygiene
- Drinking unboiled water
Symptoms
The infection itself has no specific symptoms - complaints arise due to the diseases it causes. Many infected people feel healthy. Reasons to test for H. pylori include dyspepsia, a history of ulcers, a family history of stomach cancer, long-term use of NSAIDs, and unexplained anemia.
- Pain and burning in the pit of the stomach, “hungry” and night pain
- Heaviness after eating, early satiety
- Nausea, belching, bad taste
- Heartburn
- Weakness with concomitant anemia
Tests for Helicobacter: which one to choose
For primary diagnosis and treatment control, methods that detect live bacteria are used: urease breath test and stool test for H. pylori antigen. If gastroscopy is needed for other reasons, the bacterium is determined by biopsy. A blood test for antibodies only shows the fact of encountering an infection and remains positive long after recovery, so it is not suitable for monitoring eradication. Important: 2 weeks before the test, stop taking proton pump inhibitors, and 4 weeks - antibiotics and bismuth preparations, otherwise the result may be false negative.
- 13C breath urease test
- Helicobacter pylori antigen in stool
- Rapid urease test and histology during gastroscopy
- IgG antibodies in the blood - for initial screening only
- Control of eradication - no earlier than 4 weeks after completion of the course
Treatment and prevention
Eradication therapy is the simultaneous administration of a proton pump inhibitor and two or three antibacterial drugs, sometimes with the addition of bismuth, usually for 14 days. The doctor chooses the regimen, taking into account previously taken antibiotics, allergies and local bacterial resistance. You cannot interrupt the course or reduce the dose: this reduces the effectiveness and creates resistance to H. pylori. A month after the end of treatment, a control test is required. If the bacteria persists, a different regimen is prescribed. Family members living together with complaints should also be examined and, if necessary, treated.
- Wash your hands before eating and after using the toilet
- Use individual dishes and toothbrush
- Don't try baby food from your baby's spoon
- Drink boiled or bottled water
- Do not self-medicate with antibiotics