A Helicobacter pylori infection occurs when bacteria called Helicobacter pylori infected the stomach (in childhood). As a rule, a Helicobacter pylori infection is unproblematic, but in acute conditions it can cause stomach ulcers or even stomach cancer.
What is Helicobacter pylori infection?
Helicobacter pylori infection is caused by Helicobacter pylori - a tiny bacterium in the stomach. At least half of the world's population is infected with the bacterium, so the infection can be considered one of the most common in the world.
Even so, over 80 percent of infected people are asymptomatic. It is therefore believed that Helicobacter pylori may play an important role in natural gastric ecology and in protection against some diseases. The age at which this bacterium was acquired appears to influence a pathological outcome of Helicobacter pylori infection.
A pathological Helicobacter pylori infection of the stomach causes permanent inflammation of the stomach (chronic gastritis). About 10-20% of people with Helicobacter pylori infection develop gastric and duodenal ulcers. Helicobacter pylori infection is also associated with a 1-2 percent risk of gastric cancer.
causes
Helicobacter pylori infection is contagious from person to person through direct contact with saliva, vomit or feces, although the exact route of transmission is not known. Studies suggest that Helicobacter pylori infection is more easily transmitted via the gastric mucosa than via saliva, i.e. it can also spread via contaminated food or water.
The bacterium survives the acidic pH value in the stomach and digs into the gastric mucus via flagella in order to get close to the gastric epithelial cell layer. The injected cysteine-rich proteins trigger inflammatory processes of a Helicobacter pylori infection and indicate a reaction of the immune system.
Since most people contract Helicobacter pylori infection in childhood, risk factors should be looked for especially in childhood. These include living in cramped conditions and inadequate hygienic conditions, which is why the risk of Helicobacter pylori infection is higher in developing countries.
Symptoms, ailments & signs
In many cases, Helicobacter pylori infection does not initially cause any symptoms. After an infection, those affected can live without symptoms for years. As a rule, chronic stomach inflammation (gastritis) occurs after a certain period of time. This is particularly noticeable in the form of markedly burning pain in the upper abdomen.
Sometimes there is also stomach pain and severe stomach pressure. Furthermore, those affected perceive a feeling of fullness quickly when eating. Symptoms such as persistent bloating, heartburn, bad breath, frequent belching, loss of appetite, nausea and rarely nausea are also possible. In rare cases, a fever occurs as part of a Helicobacter pylori infection.
Since the vast majority of patients develop a stomach or duodenal ulcer, other symptoms can occur. Depending on the location of the ulcer, symptoms may either improve or worsen for a short time after eating. It can be particularly painful at night. In addition, gas, diarrhea and irregular bowel movements often occur.
If ulcers are present, bleeding is common. Those affected recognize this by the characteristic black stool (tarry stool). Due to the disturbed intestinal flora, symptoms such as lack of energy, fatigue and sleep disorders occur in the long term. A Helicobacter pylori infection can also trigger relapses of neurodermatitis and psoriasis. Those affected often notice itchy skin.
Diagnosis & course
Most people who are infected with Helicobacter pylori infection will not have symptoms. In the event of burning pain in the abdomen, nausea, vomiting, frequent belching, flatulence or severe weight loss, a doctor should be consulted in the medium term.
An immediate doctor's visit to clarify a Helicobacter pylori infection is recommended if the patient has severe or persistent abdominal pain, difficulty swallowing, bloody or black tarry stools, and vomiting that looks like coffee grounds.
Non-invasive diagnostic methods are a blood antibody test, a stool antigen test or a C breath test, in which labeled drinks are taken to detect a Helicobacter pylori infection.
The most reliable method for detecting Helicobacter pylori infection is a biopsy during an endoscopy with a rapid urease test. In addition, a urine ELISA test would also be possible, whereby none of the test methods for diagnosing a Helicobacter pylori infection is completely error-free.
Complications
The Helicobacter pylori infection causes serious complaints and complications in the patient's stomach. In the worst case, it can lead to stomach cancer, which can also be fatal for those affected. As a rule, the person concerned suffers from stomach pains and stomach jokes. These pains can occur after eating or in the form of resting pains and reduce the patient's quality of life enormously.
Flatulence and heartburn also occur. Diarrhea often occurs, which is usually accompanied by vomiting and nausea. Everyday life is made considerably more difficult for the patient by the Helicobacter pylori infection. Familiar activities are no longer possible without further ado. The patient's resilience also drops enormously, so that no more sporting activities can be carried out.
Weight loss and possibly deficiency symptoms occur. Helicobacter pylori infection is treated with the help of antibiotics, with usually no further complications. Without treatment, the symptoms do not go away on their own and stomach cancer develops, which if left untreated can lead to patient death.
When should you go to the doctor?
Helicobacter pylori infection should always be examined and treated by a doctor. If left untreated, this disease can, in the worst case, lead to stomach cancer and thus to death of the person affected. A doctor should usually be seen if the person concerned has severe pain in the stomach or abdomen. This pain is permanent and is often accompanied by heartburn.
Flatulence or diarrhea can also indicate a Helicobacter pylori infection if these symptoms persist and do not depend on the food consumed. In many cases, vomiting or nausea also occurs. Should these symptoms occur, a doctor must always be consulted.
Often, severe and sudden weight loss is also an indication of the disease. In the further course, the Helicobacter pylori infection can also lead to bloody and thus black stool, which can also lead to a panic attack in some patients. Medical treatment is then necessary at the latest.
As a rule, Helicobacter pylori infection can be treated relatively easily with the help of antibiotics, so that it is sufficient for the person affected to see a general practitioner. In serious cases or emergencies, however, the hospital can also be visited. The disease usually progresses positively without complications.
Doctors & therapists in your area
Treatment & Therapy
To prevent the bacteria from developing resistance to a particular antibiotic, Helicobacter pylori infection is usually treated with several antibiotics. Since an acute Helicobacter pylori infection can damage the protective coating of the stomach and the small intestine and thus lead to the formation of gastric ulcers, drugs to reduce acid formation are also prescribed in order to heal the gastric mucosa.
The standard initial treatment is "triple therapy", consisting of proton pump inhibitors such as omeprazole and the antibiotics clarithromycin and amoxicillin. If repeat tests show that treatment of the Helicobacter pylori infection has not been successful, further use of different antibiotic combinations is indicated. The increasing prevalence of antibiotic resistance has now also led to the development of quadruple therapies that add a bismuth colloid such as bismuth subsalicylate.
Levofloxacin is also used as part of therapy to treat clarithromycin-resistant strains of Helicobacter pylori infection. Recent studies have shown that ingestion of lactic acid bacteria has a suppressive effect on Helicobacter pylori infection. A supplementary diet with yogurt containing lactobacillus and bifidobacterium therefore appears to be advisable.
Outlook & forecast
The prognosis for Helicobacter pylori infection varies. Almost half of the population in Germany is infected with this bacterium. Many sufferers do not show any symptoms, regardless of how long the infection has existed.
Other patients develop chronic inflammation of the gastric mucosa as well as gastric and duodenal ulcers. Continuous exposure to Helicobacter pylori can also lead to stomach cancer or what is known as MALT lymphoma in the stomach. Initially, unspecific symptoms such as upper abdominal pain, bloating, belching and heartburn are often given as complaints.
Once diagnosed, however, treatment should begin to reduce the risk of stomach ulcers. However, a simple therapy with antibiotics is not effective. The bacteria love acids and are therefore not so easy to fight with antibiotics. The bacterium can only be combated as part of a triple or quadruple therapy.
In triple therapy, in addition to the administration of two antibiotics, a proton pump inhibitor is also administered, which lowers the pH value. However, this therapy fails in stubborn cases. Then a bismuth salt is administered as part of the quadruple therapy. The treatment success with this therapy is then 95 percent.
The persistence of a Helicobacter pylori infection is often based on reinfection of the stomach by bacteria in plaque. Patients with periodontal disease are particularly affected. Sometimes there are also bacterial strains with a certain antibiotic resistance. A complete new infection is also possible in about one percent of cases.
prevention
The increasing resistance to antibiotics increases the need for new therapeutic strategies for the prevention of Helicobacter pylori infection. Extensive vaccine studies have already shown promising results for therapies to strengthen the digestive flora. Practice shows that various foods containing probiotics and flavonoids such as green tea, red wine, broccoli, sprouts or garlic prevent the symptomatic course of Helicobacter pylori infection.
Aftercare
After the eradication therapy, i.e. the drug control of the Helicobacter pylori bacterium, has been carried out, the success of the therapy must be checked. To do this, at least four to six weeks must have passed between the end of the medication administration and the success control. Gastro-protective drugs such as omeprazole should also be discontinued two weeks before the check-up, as this can falsify the follow-up check-up.
In patients with a complicated course who have suffered, for example, a gastric ulcer or gastric bleeding due to chronic gastric mucosal inflammation, the control should be carried out endoscopically. Here the patient receives a gastroscopy including a biopsy from the gastric mucosa.
As with the diagnosis, rapid urease tests are carried out with the samples taken in order to be able to draw conclusions about the Helicobacter pylori load by determining the pH change. Non-invasive therapy monitoring is sufficient for patients without gastric ulcer. This is sufficient for the majority of patients and is carried out with a breath test or a stool antigen test.
If the eradication therapy has failed, treatment alternatives and possible resistance development must be considered together with the doctor. If the bacterium has been successfully eliminated, patients can normally eat normally again.To support and protect the affected gastric mucosa, particularly spicy and acidic foods and smoking should be avoided.
You can do that yourself
The Helicobacter pylori infection is primarily noticeable for those affected by the unpleasant symptoms of gastritis. While the removal of the bacterium is in many cases carried out by the doctor's drug therapy, the patient can contribute a great deal to rapid symptom relief even in everyday life.
This is particularly true with a view to avoiding further strain on the irritated mucous membrane of the stomach. So it is very important to consistently avoid stimulants such as nicotine, alcohol and coffee. Fatty, spicy and lavish meals also make it more difficult for the stomach to regenerate and should ideally be replaced by several smaller and non-stressful meals.
Caution is also advisable with fruit acid. Even if a glass of orange juice is often valued for its vitamins, it irritates an inflamed stomach lining even more. Ideal drinks for Helicobacter pylori infection are still mineral water or unsweetened herbal teas.
Mental stability is also helpful with Helicobacter pylori infection, as with many other gastric diseases, for a quick recovery. In this context, it often supports healing if those affected reduce stress factors from the private and professional area as best as possible. In addition, a sufficient amount of sleep is necessary. Relaxation methods such as progressive muscle relaxation, dosed endurance training or yoga help with severe mental stress.
