Helicobacter pylori infection occurs when bacteria called Helicobacter pylori have infected the stomach (in childhood). As a rule, a Helicobacter pylori infection is unproblematic, but in acute conditions it can cause gastric ulcers and even gastric cancer.
What is Helicobacter pylori infection?
According to ABBREVIATIONFINDER.ORG, Helicobacter pylori infection is caused by Helicobacter pylori – a tiny bacterium in the stomach. At least half of the world’s population is infected with the bacterium, so the infection can be considered one of the most widespread in the world.
Despite this, over 80 percent of infected people are asymptomatic. It is therefore believed that Helicobacter pylori may play an important role in natural gastric ecology and protection against some diseases. The age at which this bacterium was acquired appears to influence a pathologic outcome of Helicobacter pylori infection.
A pathological Helicobacter pylori infection of the stomach causes permanent inflammation of the stomach ( chronic gastritis ). About 10-20% of patients with Helicobacter pylori infection develop gastric and duodenal ulcers. Helicobacter pylori infection is also associated with a 1-2 percent risk of gastric cancer.
Helicobacter pylori infection is contagious from person to person through direct contact with saliva, vomit, or feces, although the exact route of transmission is not known. Studies suggest that Helicobacter pylori infection is more easily transmitted through the gastric mucosa than through saliva, so it can also spread through contaminated food or water.
The bacterium survives the acidic pH in the stomach and burrows into the gastric mucus via flagella to get close to the gastric epithelial cell layer. The injected cysteine-rich proteins trigger inflammatory processes of a Helicobacter pylori infection and indicate a reaction of the immune system.
Since most people contract Helicobacter pylori infection in childhood, risk factors are primarily to be found in childhood. Above all, these include living in cramped conditions and inadequate hygienic conditions, which is why the risk of Helicobacter pylori infection is higher in developing countries.
Symptoms, Ailments & Signs
In many cases, a Helicobacter pylori infection initially causes no symptoms. After an infection, those affected can live without symptoms for years. As a rule, chronic inflammation of the stomach ( gastritis ) develops after a certain period of time. This is particularly noticeable in the form of distinctive burning pain in the upper abdomen.
Sometimes there is also stomach pain and strong stomach pressure. Furthermore, those affected also perceive a rapid feeling of satiety when eating. In addition, symptoms such as a persistent feeling of fullness, heartburn, bad breath, frequent belching, loss of appetite, nausea and, rarely, nausea are possible. In rare cases, fever occurs as part of a Helicobacter pylori infection.
Since a gastric or duodenal ulcer forms in the vast majority of patients, other symptoms can occur. Depending on the location of the ulcer, symptoms may either improve or worsen in the short term after eating. The pain can be particularly severe at night. In addition, flatulence, diarrhea and irregular bowel movements often occur.
If ulcers are present, bleeding is common. Those affected recognize this by the characteristically black-colored stool (tarry stool). The disturbed intestinal flora also causes symptoms such as lack of energy, tiredness and sleep disorders in the long term. A Helicobacter pylori infection can also trigger flare-ups of neurodermatitis and psoriasis . Those affected often notice itchy skin.
Diagnosis & History
Most people infected with Helicobacter pylori infection have no symptoms. If you have burning pains in your abdomen, nausea, vomiting, frequent belching, flatulence or severe weight loss, you should consult a doctor in the medium term.
Immediate visit to a doctor for Helicobacter pylori infection is recommended if you have severe or persistent abdominal pain, difficulty swallowing, bloody or black tarry stools, or vomit that looks like coffee grounds.
Non-invasive diagnostic methods are a blood antibody test, a stool antigen test or a C breath test in which labeled drinks are consumed to detect Helicobacter pylori infection.
The most reliable method for detecting Helicobacter pylori infection is a biopsy during an endoscopy with a rapid urease test. In addition, a urine ELISA test would also be possible, although none of the test methods for diagnosing a Helicobacter pylori infection is completely error-free.
The Helicobacter pylori infection causes serious symptoms and complications in the patient’s stomach. In the worst case, this can lead to stomach cancer, which can also be fatal for those affected. As a rule, the affected person suffers from stomach pain and abdominal pain. This pain can occur after eating or in the form of pain at rest, greatly reducing the patient’s quality of life.
Bloating and heartburn also occur. It is not uncommon for diarrhea to occur, which is usually accompanied by vomiting and nausea. Everyday life is made considerably more difficult for the patient by the Helicobacter pylori infection. Familiar activities are no longer easily possible. The patient’s resilience also drops enormously, so that no more sporting activities can be carried out.
There is weight loss and possible deficiency symptoms. Helicobacter pylori infection is treated with antibiotics, usually without any further complications. Without treatment, the symptoms do not go away on their own and stomach cancer develops, which if left untreated can lead to the death of the patient.
When should you go to the doctor?
A Helicobacter pylori infection should always be examined and treated by a doctor. If left untreated, this disease can, in the worst case, lead to stomach cancer and thus to the death of the affected person. A doctor should usually be consulted if the person concerned suffers from severe pain in the stomach or abdomen. This pain is persistent and is often accompanied by heartburn.
Flatulence or diarrhea can also indicate a Helicobacter pylori infection if these symptoms occur permanently and are not dependent on the food ingested. In many cases, there is also vomiting or nausea. If these symptoms occur, a doctor must always be consulted.
Severe and sudden weight loss is also often a sign of the disease. In the further course, the Helicobacter pylori infection can also lead to bloody and therefore black stools, which can also lead to a panic attack in some patients. At that point, medical treatment is necessary.
As a rule, the Helicobacter pylori infection can be treated relatively easily with the help of antibiotics, so that it is sufficient for the person concerned to see a general practitioner. In serious cases or in emergencies, however, the hospital can also be visited. In most cases, the course of the disease is positive without complications.
Treatment & Therapy
To prevent the bacteria from developing resistance to a particular antibiotic, Helicobacter pylori infection is usually treated with multiple antibiotics. Because acute Helicobacter pylori infection can damage the protective lining of the stomach and small intestine, leading to the formation of stomach ulcers, drugs to reduce acid production are also prescribed to help the stomach lining heal.
The standard initial treatment is “triple therapy” consisting of proton pump inhibitors such as omeprazole and the antibiotics clarithromycin and amoxicillin. If repeat tests show that treatment of the Helicobacter pylori infection was unsuccessful, further use of different antibiotic combinations is indicated. Increasingly widespread antibiotic resistance has meanwhile also led to the development of quadruple therapies that add a bismuth colloid such as bismuth subsalicylate.
Levofloxacin is also used as part of therapy to treat clarithromycin-resistant strains of Helicobacter pylori infection. Recent studies have shown that lactic acid bacteria intake has a suppressive effect on Helicobacter pylori infection. A supplementary diet with yoghurt containing lactobacillus and bifidobacterium therefore seems advisable.
Outlook & Forecast
The prognosis of Helicobacter pylori infection varies. Almost half of the population in Germany is infected with this bacterium. Many sufferers have no symptoms, regardless of how long the infection has existed.
Other patients develop chronic gastritis and gastric and duodenal ulcers. Long-term exposure to Helicobacter pylori can also lead to stomach cancer or so-called MALT lymphoma in the stomach. Initially, unspecific symptoms such as upper abdominal pain, feeling of fullness, belching and heartburn are often given as complaints.
After the diagnosis, however, treatment should begin to reduce the risk of stomach ulcers. However, a simple therapy with antibiotics is not effective. The bacteria are acid-loving and therefore not so easy to fight with antibiotics. Fighting the bacterium is only possible as part of a triple or quadruple therapy.
In triple therapy, in addition to the administration of two antibiotics, a proton pump inhibitor is also administered, which lowers the pH value. In stubborn cases, however, this therapy fails. Then, as part of the quadruple therapy, a bismuth salt is also administered. The treatment success with this therapy is then 95 percent.
The persistence of a Helicobacter pylori infection is often based on reinfection of the stomach by bacteria in plaque. Patients with periodontitis are particularly affected. Sometimes there are also bacterial strains with a certain antibiotic resistance. A complete re-infection is also possible in about one percent of cases.
Rising antibiotic resistance increases the need for new therapeutic strategies to prevent Helicobacter pylori infection. Extensive vaccine studies have already shown promising results for therapies to strengthen the digestive flora. Practice shows that various foods containing probiotics and flavonoids, such as green tea, red wine, broccoli, sprouts or garlic, prevent a symptomatic course of a Helicobacter pylori infection.
After the eradication therapy, i.e. the drug control of the Helicobacter pylori bacterium, has been carried out, the success of the therapy must be checked. For this purpose, at least four to six weeks must have elapsed between the end of the administration of the medication and the success check. Medicines that protect the stomach, such as omeprazole, should also be discontinued two weeks before the check-up, as this can falsify the follow-up check-up.
In patients with a complicated course, such as a stomach ulcer or stomach bleeding caused by chronic inflammation of the gastric mucosa, the control should be carried out endoscopically. Here the patient gets a gastroscopy including a biopsy of the gastric mucosa.
Just as with the confirmation of the diagnosis, rapid urease tests are carried out on the samples taken in order to be able to deduce the contamination with Helicobacter pylori by determining the pH change. In patients without a gastric ulcer, non-invasive therapy control is sufficient. This is sufficient for the majority of patients and is carried out with a breath test or a stool antigen test.
If the eradication therapy has failed, therapy alternatives and possible resistance development must be considered together with the doctor. If the bacterium has been successfully eliminated, patients can usually eat normally again. To support and protect the attacked gastric mucosa, particularly spicy and acidic foods and smoking should be avoided.
You can do that yourself
The Helicobacter pylori infection is primarily noticeable for those affected by the unpleasant symptoms of gastritis. While in many cases the bacterium is removed by the doctor’s drug therapy, the patient himself can do a lot in everyday life to quickly relieve the symptoms.
This applies in particular with regard to not further stressing the irritated mucous membrane of the stomach. So it is very important to consistently avoid stimulants such as nicotine, alcohol and coffee. Fatty, spicy and sumptuous meals also make it more difficult for the stomach to regenerate and should ideally be replaced by several smaller and non-stressful meals.
You should also be careful with fruit acid. Although a glass of orange juice is often appreciated for its vitamins, it irritates an inflamed stomach lining even more. In the case of a Helicobacter pylori infection, ideal drinks are still mineral water or unsweetened herbal teas.
Mental stability is also helpful for a speedy recovery from Helicobacter pylori infection, as is the case with many other stomach diseases. In this context, it often supports healing if those affected reduce stress factors from their private and professional life as best as possible. In addition, an adequate amount of sleep is necessary. Relaxation methods such as progressive muscle relaxation, dosed endurance training or yoga can help in the event of severe mental stress.