Helicobacter pylori Lactose intolerance Bacterial overgrowth Exocrine Pancreatic Insufficiency

 

HEALTH SECTION/HELICOBACTER PYLORI

 

What is it?

Helicobacter pylori is a highly mobile, spiral-shaped Gram negative bacillus surrounded by flagella. It was first isolated in 1983 by Warren and Marshall, relating this bacterium with gastric ulcers.

In people infected with the bacterium, it lives in the layer of mucous in the stomach where it produces ammonia due to its urease activity and it can therefore partially neutralize hydrochloric acid. This bacterium segregates certain proteins which attract macrophages and neutrophils, causing inflammation in the affected area. It also produces large amounts of urease, which neutralizes surrounding stomach acid during urea hydrolysis and it is through this mechanism that it is even further protected from the external medium.

 

Epidemiology

Helicobacter pylori infection is very common. The prevalence of Helicobacter pylori varies between different groups of the population and within the same group. The risk of infection in people from developed countries throughout their entire lifetime is between 40% and 60%, while it is more than 90% in developing countries where approximately 50% of the population is infected by the age of 10 years.

 

Pathologies and complications

Helicobacter pylori has been associated with different diseases, most of which concern the digestive tract.

The involvement of these bacteria in active chronic gastritis, their association with gastroduodenal ulcers and their inclusion by the IARC (World Health Organization cancer study group) among Group 1 carcinogens in 1994, have made it one of the microorganisms of greater interest in human pathology.

The bacterium causes infection in over half the population and can bring about complications such as:

  • Chronic gastritis: most common inflammatory process in humans and closely related to Helicobacter pylori infection.
  • Duodenal ulcer and Gastric ulcer: Perforations in the intestinal or stomach mucous
  • MALT lymphoma: A lymphoma occurring predominantly in adult age, most common in women and it makes up 5-10 % of all gastric neoplasias.
  • chronic recurrent pain or discomfort in the upper abdomen
  • Gastric cancer: La infección por Helicobacter pylori es considerado un factor de riesgo en el desarrollo del cáncer de estómago.

 

Recommended tratment

The recommended guidelines are: treatment must be well-tolerated, easy to comply with and have an eradication rate of at least 85%. The risk-benefit ratio must always be assessed.

Treatment must always be that indicated by the prescribing physician.

 

Diagnosis

There are different techniques for diagnosing Helicobacter pylori:

 

References

  • Forman D. The prevalence of Helicobacter pylori infection in gastric cancer. Aliment. Pharmacol. Ther. 1995;9 Suppl 2:71-6.
  • Kuipers EJ, Thijs JC, Festen HP. The prevalence of Helicobacter pylori in peptic ulcer disease. Aliment. Pharmacol. Ther. 1995;9 Suppl 2:59-69.
  • Gisbert JP, Pajares JM. Review article: 13C-Urea breath test in the diagnosis of Helicobacter pylori infection: a critical review. Aliment. Pharmacol. Ther. 2004 Nov. 15;20 (10):1001-17.
  • Gisbert JP, Pajares JM. 13C-Urea breath test in the management of Helicobacter pylori infection. Dig Liver Dis 2005 Dec; 37 (12):899-906.
  • Logan R.P.H. Urea Breath test in the management of Helicobacter pylori infection. Gut 1998;43 Suppl. 1:S47-S50.
  • Parente F, Bianchi Porro G. The 13C-Urea breath test for non-invasive diagnosis of Helicobacter pylori infection: which procedure and which measuring equipment? Eur J Gastroenterol Hepatol 2001. July 13 (7):803-806.
  • Gisbert JP, Ducons J, Gomollón F, Domínguez-Muñoz JE, Borda F, Miño G, Jiménez I, Vázquez MA, Santolaria S, Gallego S, Iglesias J, Pastor G, Hervás A and Pajares JM. Validation of the 13C-Urea breath test for the initial diagnosis of Helicobacter pylori infection and to confirm erradication after treatment. Rev Esp Enferm Dig 2003; 95 (2):121-126.
  • Bazzoli F. et al. Validation of the 13C-Urea breath test for the diagnosis of Helicobacter pylori infection in children: a multicenter study. Am J Gastroenterol 2000; 95: 646-650.
  • Canete A, Abunaji Y, Alvarez-Calatayud G, DeVicente M, González-Holguera JA, Leralta M, Pajares JM, Gisbert JP. Breath test using a single 50-mg dose of 13C-Urea to detect Helicobacter pylori infection in children. J Pediatr Gastroenterol Nutr 2003 Jan;36 (1):105-11.
  • Leodolter A, Armin U, Domínguez Muñoz JE, Malfertheiner P. Less Sensitivity of the 13C-Urea breath for the diagnosis of Helicobacter pylori infection by using orange juice as test drink. Gut 1997;40: 459-462.

 

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