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HELICOBACTER
PYLORI INFECTION
 WHAT
IS HELICOBACTER PYLORI?
Helicobacter
pylori ( H pylori or "Hp" for short) is a spiral-shaped
bacterium or germ. It is found in the
stomach in over 90% of patients with duodenal ulcers and
80% of patients with gastric ulcers. If
this
germ is present in the stomach of a person with ulcer
disease, then even if the ulcer is treated and
healed with
ulcer-healing drugs, there is a high chance that
the ulcer may recur months or years subsequently.
This is the reason why peptic ulcer is usually a
chronic relapsing condition that may trouble a patient
for years.
Chronicity of an ulcer also increases the risk of
ulcer complications such as bleeding and perforation.
Therefore, experts now advise that if H pylori is
present in association with ulcer disease, antibiotics
should be given to eradicate it. If this is successful,
the risk of future recurrence of ulcer is greatly
reduced. |
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Helicobacter
Pylori |
METHODS
OF DETECTION
If endoscopy is performed and peptic ulcer
is diagnosed, the doctor can take pinch biopsies of the
stomach during endoscopy to test for the germ either chemically,
by microscopic examination or by culture.
Another method of detection is by use of a special breath
test. In this test, the patient swallows a special tablet
containing labelled urea, which dissolves in the stomach.
If H pylori is present, it digests the swallowed urea,
releasing a labelled form of carbon dioxide which is measured
in the exhaled breath.
There is also a blood test that can be done to detect
antibodies to H pylori, however, this is less reliable
and may be positive for a long time even after the germ
has been eradicated with antibiotics.
SHOULD
YOU TEST FOR HELICOBACTER PYLORI?
There is no need to test for H pylori unless
the patient has peptic ulcer, as this germ may be present
in the stomachs of normal people and may cause no symptoms.
If a patient has peptic ulcer, then the detection of H
pylori will help the doctor decide if antibiotics should
be given to eradicate the germ so as to reduce the risk
of recurrence of ulcer disease.
THE
UREA BREATH TEST
The
urea breath test can be performed for patients with peptic
ulcer. If H pylori is detected, antibiotics are given
to eradicate it and the breath test is repeated one month
later to confirm that the germ is no longer present.
The urea breath test is extremely simple for the patient
to do. After a four hour fast, a tablet containing labelled
urea is swallowed with water. After 30 minutes, a breath
sample is collected and analysis of the latter will show
whether H pylori is present in the stomach or not.
The advantage of the breath test for the patient is that
it is entirely non-invasive. Following the diagnosis of
duodenal ulcerby endoscopy and the detection of H pylori,
the success of treatment with antibiotics can be determined
by the breath test without the need for a repeat endoscopy.
This saves the patient further discomfort and the expense
of repeat endoscopy.
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