Helicobacter Pylori

Helicobacter pylori or H. pylori (幽門螺旋菌) is a bacterium that lives in the stomach and duodenum and is the only bacterium that can survive in the gastric acid environment. H. pylori infection may cause indigestion, gastritis, gastrointestinal ulcers, anemia or decreased platelets, and in severe cases may increase the risk of gastric cancer. It has a worldwide prevalence rate of approximately 50%. Helicobacter pylori is mainly transmitted through the patient's feces and saliva, so people who live with the patients harboring the bacterium have a higher chance of infection. Strict personal hygiene, detection and complete treatment offers the best preventive measures against infection. 

Causes of Helicobacter pylori infection  

The medical community still does not fully understand Helicobacter pylori infection's exact cause and transmission route. It is estimated that it is mainly transmitted through saliva, vomitus, excrement, sewage, contaminated food and water. There are also the following risk factors: 

• Over 40 years old 
• Smoking 
• Family history of untreated infection 
• Family members living together with infected individuals 
• Children living with infected parents/care-givers 

Helicobacter pylori disease symptoms    

Helicobacter pylori can lie dormant for years without any signs or symptoms. The following are symptoms that may occur: 

• Abdominal pain or burning sensation 
• Abdominal pain is worse on an empty stomach 
• Nausea 
• Frequent hiccups 

• Loss of appetite 
• Flatulence 
• Sudden weight loss 
• Excessive gas and stomach pain 

Since the above symptoms resemble ordinary gastrointestinal discomfort, patients often take them lightly, self-medicate or ignore them altogether. Eventually, the lining (mucosa) of the stomach and duodenum may become repeatedly inflamed, which can lead to gastritis or duodenitis, peptic or duodenal ulcers and even gastric cancer. There is also a high risk of cross-infection among people living together with an infected individual, such as in care homes. 

Diagnostic methods for Helicobacter pylori  

Stool inoculum test (Fecal Antigen Assay) 

• Checks stool for foreign protein antigens related to Helicobacter pylori. 

Gastroscopy 

• A long tube with a tiny camera is inserted from the throat and esophagus into the stomach and duodenum, allowing doctors to check for any abnormalities in the upper gastrointestinal tract and to take tissue samples for biopsy and testing for the presence of the bacterium (through the rapid urease or CLO (Campylobacter-like organism) test). 

Air blow test (Urea Breath Test) 

• The patient first takes a medication containing a tracer element (carbon-13 or carbon-14) after baseline carbon dioxide (CO2) measurements. If the bacteria is present in the stomach, its urease enzyme will react chemically with the drug, and then the gas (with tagged carbon dioxide (CO2)) exhaled by the patient can be detected and measured. 

Helicobacter pylori treatments 

• Standard treatment is to undergo a two-week course of medication, taking two high-dose broad-spectrum antibiotics and a proton pump inhibitor (Triple Therapy); other treatment regimens may include Bismuth subsalicylate (Quadruple Therapy) 
• Helicobacter pylori has developed drug resistance in recent years. If the initial treatment fails, alternative antibiotics may be added to eliminate Helicobacter pylori and newer regimens are also currently available. 

• After the treatment, the patient can undergo another insufflation/breath test to ensure the stomach has completely cleared of Helicobacter pylori.  

Helicobacter pylori prevention methods 

• Wash your hands with soap after using the toilet, before and after preparing food, and before eating 
• Avoid eating unclean or undercooked food 
• Avoid eating in environments with poor hygiene 
• Maintain balanced nutrition to prevent iron deficiency anemia 
• Eating more cruciferous vegetables may help fight cancer 
• Avoidance of smoking an excessive alcohol intake 
• Being tested for recurring symptoms of gastritis or peptic ulcer disease

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