Helicobacter pylori (Helicobacter pylori) - A Complete Guide

Helicobacter pylori (H. pylori) is a bacterium that inhabits the gastric mucosa and infects more than half of the world’s population. It often causes chronic gastritis, gastric and duodenal ulcers, and sometimes represents a risk factor for the development of gastric cancer. Therefore, its timely diagnosis and adequate treatment are vitally important.

What is Helicobacter pylori and why is it dangerous?

Helicobacter pylori is a spiral-shaped gram-negative bacterium adapted to survive in the extremely acidic environment of the stomach. It produces the enzyme urease, which converts urea into ammonia. This ammonia neutralizes gastric acid in the immediate vicinity of the bacterium, helping it survive. The long-term presence of H. pylori in the stomach causes inflammation and progressive damage of the mucosa, forming the basis for the development of serious diseases.

How common is Helicobacter pylori infection?

Helicobacter pylori infection is found in more than 50% of the global population, making it one of the most common bacterial infections. In developing countries, the prevalence rate is generally higher than in developed countries, closely related to hygiene standards and socio-economic conditions.

How is Helicobacter pylori transmitted?

Helicobacter pylori is mainly transmitted through direct contact or contaminated food and water.

• Oral-oral route: the most common route, especially among family members, for example through exchange of saliva, sharing utensils, or personal hygiene items.
• Fecal-oral route: through contaminated food or water containing the bacterium, often under insufficient hygiene standards.

When should infection be suspected?

Helicobacter pylori infection should be suspected if you have characteristic gastrointestinal symptoms or certain risk factors. It is important to note that the bacterium is often asymptomatic, but its presence still causes mucosal damage.

1. Pain, burning, or discomfort in the stomach area, especially on an empty stomach or after eating.
2. History of gastric or duodenal ulcer.
3. Family history of gastric cancer.
4. Unexplained iron deficiency anemia.
5. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
6. Chronic gastritis, erosions, or ulcer detected during gastroscopy.
7. Nausea, vomiting, bloating, loss of appetite.

What diseases does Helicobacter pylori cause?

Helicobacter pylori is a causative or contributing factor of many gastrointestinal diseases, including chronic inflammatory and oncological pathologies.

Main diseases caused by the bacterium:

• Chronic gastritis.
• Erosive and ulcerative processes in the stomach and duodenum.
• Gastric cancer (adenocarcinoma) - recognized as a Group I carcinogen.
• Gastric lymphoma (MALT lymphoma).

How should testing for Helicobacter pylori be performed?

Diagnosis is performed by non-invasive and invasive methods.

Main diagnostic methods:

• Stool antigen test.
• Urea breath test.
• Esophagogastroduodenoscopy (gastroscopy) with biopsy.
• Histological examination.
• Rapid urease test (CLO test).
• Bacteriological culture with antibiotic susceptibility testing.

Important notes:

• Serology (IgG) is not used to confirm eradication.
• Testing should be performed at least 2 weeks after stopping PPIs and 4 weeks after antibiotics to avoid false-negative results.

How to prevent Helicobacter pylori infection?

Prevention is possible through hygiene and protective measures:

• Personal hygiene - thorough hand washing.
• Food and water safety.
• Use of personal utensils.
• Testing and treatment of family members.
• Timely medical consultation.

Treatment and Post-treatment Recommendations

Treatment is complex and requires strict adherence.

• Complete the full antibiotic course.
• Perform eradication control 4-6 weeks after treatment.
• Family-based approach.
• Prevent antibiotic resistance.

Conclusion

Helicobacter pylori is a serious bacterium that can significantly damage the gastrointestinal system. Timely diagnosis, proper treatment, and preventive measures are crucial for your health.

Author: Natia Razmadze – Gastroenterologist.