Helicobacter Pylori
Q1. What is Helicobacter pylori?
Helicobacter pylori (H. pylori) is a common bacterium that can be found in the human stomach. It only survives in the extremely acidic environment, and is usually transmitted from person to person through vomitus or stool.
Q2. What are the common symptoms?
H. pylori infection is usually asymptomatic. It is usually detected by a blood test or a breath test during physical examination. In many cases, the presence of H. pylori is confirmed when patients undergo gastroscopy for other reasons, such as endoscopy.
Q3. How to diagnose Helicobacter pylori infection?
H. pylori infection is often diagnosed during consultation with a family doctor or a specialist. It involves reviewing one’s medical history and conducting a physical examination. Further tests may be necessary, such as a fasting breath test. The test is to detect H. pylori by measuring carbon dioxide in exhaled breath. This is the most accurate non-invasive test method.
The second method is a blood test, which detects the presence of H. pylori antibodies. However, when the antibody levels are inaccurate or low, the test results can be false positive or negative.
The third method is a stool test. It is less convenient, and thus less commonly used than the other test methods. The most direct method is endoscopy, commonly known as gastroscopy. It directly examines the stomach for H. pylori infection by inserting a tube through the mouth and into the stomach.
Q4. How to treat Helicobacter pylori infection?
Once H. pylori infection is confirmed via a non-invasive examination or a gastroscopy, the doctor will explain to the patient why the eradication of H. pylori is important. H. pylori infection usually causes indigestion, early satiety, and abdominal discomfort. When inflamed, the stomach is less able to absorb nutrients, which often affects the appetite, or causes nausea and vomiting.
For patients diagnosed with H. pylori infection, a combination of three medications may be prescribed, including two different antibiotics and one potent acid-suppressing drug, usually for two weeks.
A follow-up breath test is arranged after initial treatment to confirm the eradication of H. pylori. However, antibiotic resistance can make treatment difficult, as first-line medications may fail to eradicate the bacteria. In such cases, second or third-line treatment courses may be required. A gastroscopy may be recommended to obtain tissue samples in the gastric antrum for culturing. It helps explain the reasons for failed eradication, and determine if other antibiotics are needed. Sometimes a doctor may discover during follow-up consultation that the patient's family members are also infected with H. pylori. For a successful eradication, the family's condition must also be considered, such as if other family members are infected and if symptoms occur in them.
Q5. Is Helicobacter pylori related to gastric cancer?
If H. pylori infection remains untreated, over years, it can increase the risk of atrophic gastritis and gastric cancer. While the associated risk is not high, it does increase in high-risk individuals such as men, long-term smokers and those with a family history of gastric cancer. Doctors can assess one’s risk of developing gastric cancer by observing any changes in the gastric mucosa during gastroscopy. Early treatment of H. pylori infection can reduce the chance of mucosal changes induced by stomach inflammation and also the risk of developing into gastric cancer, especially in young patients who are recently infected and treated early.
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