HELICOBACTER PYLORI

Helicobacter pylori is a bacterium that causes ulcers in stomach and  upper small bowel as well as gastric cancers.

It is present in approximately one-half of the world's population.
In the United States and other developed countries, infection is unusual during childhood but becomes more common during adulthood. However, in developing countries, most children are infected with H. pylori before age 10.

RISK FACTORS 

H. pylori is probably spread by consuming food or water contaminated with fecal matter. Children living in developing countries may become infected after swimming in contaminated pools, streams, or rivers, by drinking contaminated water, or by eating uncooked vegetables.

SYMPTOMS 

Most individuals with  this infection have no symptoms.
Some people develop more serious problems, including stomach or duodenal ulcers. Common complaints include pain or discomfort (usually in the upper abdomen), bloating, feeling full after eating ONLY a small amount of food, and dark or tar-colored stools.
People who live in countries in which infection occurs at an early age are at greatest risk of stomach cancer.

DIAGNOSIS
 
Blood tests 
Blood tests can detect specific antibodies (proteins) that the body's immune system develops in response to the infection.
Blood tests are not recommended for follow up testing as  the antibody detected by the blood test often remains in the blood long time treatment, even if the infection is eliminated.
Breath tests 
Urea breath tests
Stool tests 
 Tests are available that detect H. pylori proteins in stool.
Endoscopy  
During an endoscopy, a flexible tube is inserted through the mouth into the esophagus, stomach, and upper region of the small intestine. The tube contains a light and camera, which can be used to examine the various areas. Small tissue samples (biopsy samples) can be taken from the stomach, which are then tested for H. pylori.

WHO SHOULD BE TESTED?

Patients with symptoms 
Diagnostic testing for H. pylori infection is done for people with active gastric or duodenal ulcers and those with a past history of ulcers.
Patients without symptoms
Generally not recommended.
Considered for those with a family history or concern about stomach cancer, particularly individuals of Chinese, Korean, or Japanese descent who have a  higher incidence of stomach cancer.

TREATMENT
 
 Patients with a history of peptic ulcer disease, active gastric ulcer, or active duodenal ulcer associated with H. pylori infection should receive treatment for the infection.
 Treatment involves taking several medications for 7 to 14 days.

For more information , please see

      www.nlm.nih.gov/medlineplus/healthtopics.html
      www.niddk.nih.gov/
      www.cdc.gov/
      www.gastro.org
      www.acg.gi.org
      www.helico.com/