Infection due to Helicobacter Pylori

More than just an infection.

What exactly is Helicobacter Pylori?

H. Pylori is a spiral shaped bacterium, identified first in 1980, that requires a highly acidic environment to live. Its mode of transmission is oral.

Infection with H. Pylori is common. It is estimated that two-thirds of the world’s adult population is infected with the bacterium, with higher proportions of infection in developing countries. Our experience with patients from the northern border of Tamaulipas and southern border of Texas places the incidence of infection in this area at 90% of the population.

The bacterium H. Pylori is only able to infect humans when it finds a host with an abnormal gastric mucosa. In other words, it only thrives in stomachs that have a damaged lining. The bacterium has adapted to survive inside the stomach despite its highly acidic contents. This is achieved thanks to its production of a powerful urease, a substance that protects the bacteria from being harmed by the acid but that causes harmful changes in the surface of the stomach. This urease increases the stomach’s production of acid while it decreases the stomach’s ability to protect its mucosa or lining.

The bacterium cannot cause any harm if the lining of the stomach is healthy and undamaged. However, it is able to embed itself in the mucosa when it finds a stomach that is damaged or constantly irritated, remaining there for years and causing slow and progressive harm.

Infection by H. Pylori does not cause any symptoms, but instead patients show the signs of disease caused by damaged stomach lining. The severity of the symptoms are not related to the severity of the infection, but the infection and the damaged stomach lining must be treated simultaneously.

Gastric diseases associated with H. Pylori are:

Disease: % presence of bacteria:
Active chronic gastritis 98%
Gastric ulcer 50-60%
Duodenal ulcer 100%
Gastric cancer 90%
Gastric lymphoma 100%

There are different diagnostic tests for the detection of H. Pylori, including:

a) Non-invasive tests (do not require endoscopic procedure):

  • Blood test – Reliability: 88-90%
  • Antigen in feces – Reliability: 90 %
  • Breath test – Reliability: 90-100%

These tests are accomplished without the need of an endoscopic procedure, but do not determine the severity of the damage to the mucosa in the stomach; they only tell whether the bacterium is present or not.

b) Invasive tests (requiring endoscopic procedure with biopsies):

  • Rapid urease test – Reliability: 89-98%
  • Histopathology – Reliability: 93-99%
  • Bacterial culture – Reliability: 90-100%

The samples are obtained with the help of an endoscopy, which also permits the direct observation of the gastric mucosa and note the severity of the damage done by the bacterium, resulting in a more precise diagnosis.

The treatment for H. Pylori infection, consisting of a combination of strong antibiotics, must take place at the same time as the treatment for the damage found in the stomach. Once the treatment is completed, a second test must be done to confirm that the bacterium has been erradicated.