Helicobacter pylori

Helicobacter pylori is almost the only bacteria that can be accommodated in the stomach in its acid. Since this microbe has natural properties that can protect itself from stomach acid, it can live in stomach acid. It is usually transmitted to humans in childhood.

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    What is Helicobacter Pylori?

    While it causes gastritis in all infected people, it causes stomach or duodenal ulcers in approximately 1%. And in 1/1000 of patients, it can cause stomach cancer in people with an underlying genetic predisposition.
    It is known that almost half of the entire world is infected with this microbe. While it is close to 100% in the east of our country, it is considered to be around 80% in the west.
    Low socioeconomic status, difficulty in accessing healthy drinking water, having large families and common crockery increase the risk of spreading the infection.
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    What are the complaints and findings related to Helicobacter pylori microbe?

    When it is first transmitted in childhood, patients may show general symptoms such as nausea, vomiting, abdominal pain and sometimes diarrhea. The acute infection usually resolves spontaneously without the need for any treatment. In many people, the state of acute infection cannot be remembered.

    In later times, the vast majority of patients do not show any complaints due to helicobacter pylori.

    People with stomach or duodenal ulcers, on the other hand, have complaints such as heartburn, burning, pain after eating, and indigestion. If it has caused a duodenal ulcer, it can give a history such as scraping in hunger and relief when eating. People with ulcers may wake up at night with stomach pain and sometimes have pain in the back and waist.

    In things with a suitable genetic background, when stomach canceris caused, findings such as weakness, weight loss, anemia may come to the fore.

    In patients with stomach or duodenal ulcers or cancer, ulcer bleeding , narrowing or obstruction of the stomach outlet, sometimes complete perforation and perforation of the stomach wall on the basis of ulcers, and inflammatory conditions in the secondary abdominal cavity, which we call peritonitis , may occur as complications.

    How is Helicobacter pylori diagnosed?

    If you have complaints such as heartburn, burning, indigestion, gas and bloating, you should be tested for helicobacter pylori.

    When performing bacterial tests, patients should not have taken antibiotics for the last 2 weeks and proton pump inhibitors for the last week. Otherwise, the sensitivity of the tests decreases and false negatives increase.

    Urea breath test

    It is considered the gold standard in the diagnosis of Helicobacter pylori. The test is performed by giving the patient a small amount of radiolabeled urea-containing food or pills. Since people with Helicobacter pylori in their stomach break down the labeled urea, the marked carbon dioxide is released. While this marked carbon dioxide is expelled through the breath, the breath is collected by blowing into a container. If carbon dioxide marked here is detected, it is assumed that helicobacter pylori is present in the stomach. The accuracy rate is 99%.

    Helicobacter pylori Fecal Antigen test (HPSA)

    Helicobacter pylori bacteria, which descend from the stomach by pouring from the surface, can be detected in feces. The accuracy rate is around 95%.

    H. Pylori antibody test in blood

    Antibodies to helicobacter pylori bacteria are tested in blood samples. Unlike the Saw above, the antibody test can show not only the existing infection, but also the previous and cured infection. For this reason, it cannot distinguish between previous infection or active infection.

    H. pylori Culture test

    Tissue samples taken from the stomach are cultured in a laboratory environment. It is used to determine which antibiotics Helicobacter pylori is sensitive to, especially in treatment-resistant cases. It is not a common test because special environments are required for the bacteria to be produced in culture.

    Rapid urease test

    In patients who have undergone endoscopy for various reasons, the biopsy sample taken from the stomach is placed in special commercial tests containing urea. If there is Helicobacter pylori in the tissue, it converts the urea it comes into contact with into ammonia. The indicators placed in the environment turn red when they come into contact with ammonia. Helicobacter pylori is positive in samples with discoloration in this way

    How is Helicobacter pylori treated, who should be treated?

    People who have stomach complaints and have been tested and detected for Helicobacter pylori should be treated.

    However, people who do not have complaints and do not have a family history of stomach cancer should not be tested and treatment should not be required.

    The presence of helicobacter pylori should be investigated and treated in those with stomach ulcers, duodenal ulcers, those with a family history of stomach cancer, and those with MALT type stomach cancer.

    Drugs used in the treatment of Helicobacter pylori include:

    • Proton pump inhibitors
    • Amoxicillin
    • Clarithromycin
    • Metronidazole
    • Tetracycline
    • Bismuth preparations
    • Levofloxacin

    Treatments are performed with proton pump inhibitors and combinations of sometimes 2 and sometimes 3 antibiotics. Treatment periods are 7, 10 or 14 days depending on the combination type. Changes can be made in combinations according to the resistance rates to antibiotics in countries.

    Is it gone after treatment, when is it checked?

    At the earliest, 4 weeks after the treatment, preferably after 8 weeks, it is tested whether the microbe is destroyed with a urea breath test or a helicobacter pylori fecal antigen test.

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