Helicobacter pylori infection

– The information has been reviewed by Dr. Yang Pei Cheung, George

Epidemiology

According to a 2017 study conducted by the Faculty of Medicine of the Chinese University of Hong Kong, about 4.4 billion people are infected with Helicobacter pylori worldwide. Around one in every two people in Hong Kong have a Helicobacter pylori infection.

 

What is Helicobacter pylori?

Helicobacter pylori is a type of bacterium that can live in the stomach and duodenum. It parasitizes in gastric mucus and mucous cells, where it reduces the acidity of stomach acid and causes chronic gastritis. If left alone, it may evolve into gastric cancer over time.

Symptoms
Symptoms

Patients with a Helicobacter pylori infection show no symptoms during the initial stage, and can remain difficult to detect even after years of incubation. Carriers may experience bloating, excessive gas, sudden weight loss, stomach pain, loss of appetite, and other symptoms common to ordinary gastrointestinal discomfort. As Helicobacter pylori can induce chronic gastritis, 10-15% of patients will experience gastrointestinal ulcers and symptoms such as bleeding, vomiting, anemia and melena.

Transmission of Helicobacter pylori infection
Transmission of Helicobacter pylori infection

The medical field is still unsure of the exact cause of Helicobacter pylori infections and how it is spread. It is believed that infections are mainly transmitted via saliva, bodily fluids, vomit, excrement, sewage and food. Due to the variety of channels the infection can spread, it is very difficult to prevent.

Risk Factors
Risk Factors
  • Over the age of 40
  • Frequent smoking
  • Family medical history
  • Living with family members who have Helicobacter pylori infection
How is Helicobacter pylori infection diagnosed + Treatment
How is Helicobacter pylori infection diagnosed + Treatment

If Helicobacter pylori causes chronic gastritis, or mucosal lesions during advanced stage gastritis, these conditions will not disappear even if the Helicobacter pylori infection is cured. These conditions are irreversible, and may develop into gastric cancer. It is vital to check and remove Helicobacter pylori from the stomach as soon as possible to reduce any damage it may cause.

  • Blood Test: Used to detect whether antibodies against Helicobacter pylori can be found in the blood
  • Stool Antigen Test: Has a high accuracy rate, but antibiotics, antacids, and any other therapeutic drugs must be stopped two weeks before to test to avoid affecting the results
  • Breath Test: The patient ingests medicine containing urea, which will create a chemical reaction with the bacteria if it is present in the stomach that can be detected from the patient’s breath
  • Endoscopy: A sample of gastric tissue will be taken for biopsy testing and bacterial cultivation. Doctors may also use endoscopies to assess whether the gastric mucus has been damaged or if precancerous lesions are present

 

Treatment

Helicobacter pylori can be treated with a “triple therapy”, where high-dose proton pump inhibitors and two other types of antibiotics are taken for at least 7 to 14 days. This treatment can have a success rate of up to 85%. For high-risk patients, doctors may recommend they be tested again in 6 to 8 weeks to confirm that the Helicovacter pylori has been treated. If not cured, the patient will undergo a new round of treatment and testing. If a patient is successfully cured, the chances of the infection recurring is quite low.

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