Cryosurgery (Caring & Treating Since 2005)
H. pylori Diagnosis & Treatment
What is H. pylori?
H. pylori (Helicobacter pylori) is a type of bacteria that lives inside some of our digestive tracts, usually in the stomach and the upper intestines. It is a common bacteria - up to two-thirds (⅔) of us may have it in our stomachs. Most of us who have it won’t even know we have it. This bacteria is usually spread through contact with an infected person saliva, vomit or faecal matter.
What Does H. pylori Does?
For the majority of us who have it, it may never cause any symptoms at all. But for others, it can lead to inflammation of the stomach (gastritis), stomach ulcers and even stomach cancer. No one really knows why some people develop symptoms and problems, and why others are unaffected by it.
When the bacteria is present in the walls of your stomach, it causes damage to the stomach lining. The stomach lining usually protects you against the acid that is secreted by other cells of the stomach. With sufficient damage to the lining, the acid, that is normally meant to aid in digestion and protect you from other bacteria in food, is free to burn the deeper layers of the stomach. This leads to inflammation (gastritis), and also ulcers. Over many years, chronic inflammation may even become cancers or lymphomas.
H. pylori and how it causes diseases is a relatively new discovery, made by 2 doctors from Australia in 1982. The doctors who discovered it won a Nobel Prize for it in 2005!
How Do I Know If I Have H. pylori?
Some of the symptoms of gastritis include stomach pains (usually of the upper part of the stomach), nausea, bloating, belching and pain worse on an empty stomach. If you have black tarry stools or vomiting of blood, the inflammation may have developed into an ulcer.
Should you have any of these symptoms which might sound like gastritis, speak to your doctor about it. There are many conditions which can cause similar symptoms and your doctor will be the best person to go through your history with you.
What Can Be Done to Diagnose It?
H. pylori can be detected through blood, stool, and breath or with a biopsy.
Blood tests can be done to see if the body has developed defences against H. pylori. However, this may be inaccurate as these defences can persist after the infection has cleared.
A non-invasive, painless test is the “urea breath test”. This is done in a clinic setting. The doctor will take a breath sample from you, then ask you to consume a tablet containing a chemical called urea. This area is broken down by H. pylori into ammonia and carbon dioxide. After about 20 minutes, we will ask you to blow up another small plastic bag, and send your breath samples out for testing. We will compare the 2 breath samples and if the breakdown products are detected, it indicates the presence of H. pylori in your stomach. There are some instructions to be given to the patient before the test is done. Some of these include avoiding taking acid suppression medications for 2 weeks before and to fast for a few hours before the test. More instructions will be told to you by your doctor.
The other way to diagnose H. pylori is to do an endoscope through the mouth. During the endoscopy, the doctor will take a piece of tissue from your stomach and place it on a test kit containing urea. If H. pylori are present, ammonia (broken down from urea) will give a positive result. However, endoscopies are usually done for patients with alarming or persistent symptoms.
Stool testing is currently is not available commercially here, but it tests for the presence of H. pylori in the stool.
How Do I Treat It?
Are there any Follow up
Because H. pylori is a type of bacteria, it can be eradicated with antibiotics. As the course of antibiotics is longer than what is usually given for other infections, it is prudent to test for the presence of H. pylori before starting treatment. We will also give other medications to reduce the acidity of the stomach.
Most doctors would recommend a repeat test to document eradication of the bacteria, usually done 4 weeks after treatment.
If symptoms are persistent and H pylori is still present, the first round of treatment has likely failed. The doctor may recommend another round of different antibiotics.
Multiple rounds of failed treatment may indicate a drug-resistant strain of H. pylori, and in these cases, an endoscopy is recommended.
If I Do Not Have Symptoms, Should I Still Get Tested & Treated?
Testing and treatment have no clear value in an asymptomatic patient. Discuss with your doctor to find out more.
Are there any Follow up
Many people live with persistent abdominal symptoms without giving much thought to finding out the cause. The cause may very well be a chronic infection of H. pylori which can be easily tested and treated. If getting treated for H. pylori improves your quality of life, it is something you should definitely consider.
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