Helicobacter pylori, what is it and how to treat it?

Helicobacter pylori is a unique pathogen that is the causative agent of such a dangerous disease as helicobacteriosis. This is a pathology that often affects the stomach, but can also develop in the duodenum.

The name of the bacterium was due to the environment in which it lives - the pyloric stomach. A feature of the microorganism is that it is able to withstand even gastric acid. The bacterium has flagella by which it moves freely along the walls of the stomach, or is securely fixed on them.

Helicobacter Pylori can lead to the development of many diseases of the gastrointestinal tract, because, multiplying, it causes irritation of its mucous membranes and, as a result, inflammatory processes. In this case, it is not only about gastritis or peptic ulcer disease, but also about the development of an oncological process. If you start treatment in a timely manner, you can prevent the dangerous consequences that can be caused by the vital activity of this bacterium.

Discovery history

Spiral pathogenic microorganisms living in the human stomach were described 100 years ago by the Polish professor V. Yavorsky. After some time, the scientist G. Bizodzero discovered the same bacteria on the mucous membranes of the stomach in animals. For many years, this infection turned a blind eye, unaware of its danger, but in the late 1970s, scientist Robert Warren noted that these bacteria live on the inflamed gastric mucosa.

As it turned out, the vital activity of these microorganisms was studied, albeit not completely, and described by German scientists. However, in those days this did not attach much importance. Warren, having joined forces with Barry Marshall, began to conduct research to study in detail the characteristics of these bacteria. For a long period of time, it was not possible to isolate the culture of microorganisms, but scientists, nevertheless, were lucky. During Easter holidays, the laboratory staff accidentally left cups with bacterial crops not for 2, but for 5 days. Thanks to this case, scientists have observed the growth of colonies of unknown microorganisms.

Bacteria were originally called Campylobacter pyloridis, because by their characteristics they resembled microorganisms belonging to the genus Campylobacter. In 1983, scientists first published the results of their research. However, a little later, researchers had to disprove their previous discoveries, because it soon became clear that the representatives of pathogenic microflora were not related to the genus Campylobacter. Based on this, the detected microorganisms were renamed Helicobacter pylori.

To prove the ability of a microorganism to cause GAB, B. Marshall in 1985 swallowed his culture. However, there was a development not of ulcers, but of gastritis, which had passed on its own. With this experiment, the scientist was able to prove that the bacterium Helicobacter Pylori is the cause of gastritis. In 2005, Warren and Marshall received the Nobel Prize in Medicine and Physiology for their sensational discovery.

Bacteria features

The first feature of this microorganism is its ability to resist a very acidic gastric environment, while most bacteria and viruses simply die. Helicobacter pylori can also adapt to the level of gastric acidity using 2 mechanisms:

  1. When it enters the stomach, the bacterium begins to move along the mucous membranes. She does this with the help of her flagella. Hiding in the mucous membranes of the stomach, the microorganism protects their cells from excessive amounts of acids. Simply put, the bacterium "chooses" the most optimal habitat for itself.
  2. H. pylori provokes the production of ammonia, which reduces the acidity of the stomach. Due to this, the microorganism can be conveniently located on the walls of the body, remaining in its place for many years.

The second feature of the bacterium is its ability to cause inflammatory processes in the gastrointestinal tract. Multiplying, it causes the slow destruction of gastric cells, and the substances secreted by it, cause chronic inflammatory processes and gastritis. With the weakening of the mucous duodenum and stomach, ulcers and erosion begin to form, which increase the risk of developing cancer. For this reason, many gastroenterologists rightly consider Helicobacter pylori to be a provocateur of oncological processes in the stomach.

Get rid of the pathology is possible only after the advent of a course of antibiotic therapy. With the help of antimicrobial drugs, the level of gastric acidity is regulated. Specific medications can be prescribed only by a gastroenterologist, after conducting the necessary examinations and referring the patient to additional instrumental diagnostic procedures.

How is H. pylori transmitted?

Infection with this bacterium can be mainly in two ways - oral-fecal and oral-oral. However, there is a perception that the microorganism can be transferred from cat to the owner, or during the transfer of infection by flies. Small children are most susceptible to infection.

Transfer from one person to another occurs in 3 ways:

  1. Iatrogenic when infection is due to ongoing diagnostic procedures. Thus, infection can be carried out during endoscopy or other poorly sterilized medical instruments that had direct contact with the patient's gastric mucosa.
  2. Fecal-oral. The bacterium is secreted along with feces. You can become infected with bacteria by contact with contaminated water or food.
  3. Oral-oral. Gastroenterologists believe that H. pylori lives in the oral cavity. Therefore, the infection can be transmitted by kissing, using someone else's toothbrush or poorly washed cutlery.

Although Helicobacter Pylori is capable of causing histological gastritis in all infected people, signs of pathology appear in rare cases. Less often than gastritis develops gastric ulcer, and extremely rarely - stomach cancer.

Symptoms of infection

After entering the stomach, the bacterium begins to actively secrete products of its vital activity. They irritate the mucous membrane, as a result of which inflammation develops. The clinical symptoms of Helicobacter pylori depend on its form.

There are five of them, consider each of them in more detail:

  1. Latent or asymptomatic form, when an alarming person does not have any alarming symptoms, especially if his immunity is strong enough to resist Helicobacter. But even if the clinical picture does not appear, the person is still a carrier, and can infect others. With long-term stay of the bacteria in the stomach, the occurrence of serious complications, one of which is gastric cancer, is possible.
  2. Acute gastritis is a disease manifested by pain in the epigastrium, nausea, loss of appetite. The disease can become chronic with periodic relapses.
  3. Chronic gastritis. It is this pathology that is one of the main manifestations of Helicobacteriosis. During the period of exacerbation, the patient complains of stomach pains, nausea, sometimes with vomiting, headaches, loss of appetite. The patient does not leave heartburn, bloating, belching, bouts of flatulence. Also, there are non-specific symptoms in the form of bleeding gums and bad breath.
  4. Chronic gastroduodenitis, when the pathological process affects the duodenum. The clinical picture resembles the symptoms of gastritis, but with gastroduodenitis, disorders of the stool are possible, in particular, constipation. The patient loses his appetite, complains of nausea, his sleep is disturbed. Changes in the mucous membranes are detected only during endoscopy. Lesions can be mild, moderate or severe.
  5. YABZH, which can occur for other reasons (alcoholism, smoking, frequent stress, harmful work, etc.). Erosion and ulcers are formed with a deeper lesion of the mucous membranes of the stomach. The pathology is manifested by a large number of symptoms: pain in the stomach, nausea, white on the tongue, nausea, flatulence, vomiting, indigestion, heaviness in the epigastric region, heartburn, etc.

If we talk about the out-of-stomach symptoms, then the patient with helicobacteriosis has the appearance of subcutaneous or skin rash in the form of small white or pink pimples. As a rule, they are localized on the face. Often, this disease causes the development of atopic dermatitis, psoriasis, eczema, lichen planus, erythema.

The photo shows the symptoms of Helicobacter pylori: acne on the face.

Helicobacter pylori assay

Diagnostics can be invasive (endoscopy with subsequent gastric tissue biopsy) and non-invasive (laboratory tests). Of course, the most accurate and reliable is an invasive technique, because due to the sampling of the tissues of the gastric mucosa, a medical specialist conducts a thorough study of the biomaterial to detect foci of inflammation and the bacteria themselves. In addition to microscopic examination, a sample of gastric tissue may be subjected to various laboratory tests.

All laboratory tests are aimed at identifying Helicobacter pylori and assessment of its vital activity. Throughout its life cycle, the microorganism breaks down gastric urea to ammonia, thus creating favorable living conditions for itself. If you place a piece of gastric mucosa infected with Helicobacter pylori in urea, ammonia will be released. Due to this, the alkalinity level of the solution will increase, but these changes can be detected only with the help of special test strips. Indicators operate on the principle of litmus paper.

But to identify the disease does not necessarily conduct fibrogastroduodenoscopy or biopsy study - you can use another method. The test with 13 urea helps absolutely painlessly detect the presence of infection and immediately begin treatment.

Possible complications

With the timely start of therapy, the dangerous consequences can be prevented. In addition, the risk of infection of other people will be completely excluded.

If we talk about complications, they can prove themselves through development:

  • chronic or atrophy gastritis;
  • YABZH and KDP;
  • oncology of the stomach;
  • endocrine pathologies caused by atrophy of the epithelial lining of the stomach.

To avoid such consequences, self-treatment is not strictly recommended. It is better to entrust this question to a qualified gastroenterologist.

Treatment of helicobacter pylori

Before starting treatment with Helicobacter Pylori, an assessment of the degree of gastric lesion and infection of its walls is carried out. The fact is that in some people, over time, these microorganisms become one of the varieties of conditionally pathogenic microflora, so they may not show themselves.

If the bacterium does not harm the health of its carrier, the manipulation of its removal is not carried out. But to cure the infection will need the use of powerful antibacterial drugs. They, in turn, can significantly weaken the immune system and cause the development of intestinal dysbiosis.

On a note. You can not resort to the use of folk remedies for the treatment of helicobacter. The use of decoctions and infusions can only “lull” the symptoms of the disease for a while, forcing the patient to postpone a visit to the doctor. In the meantime, the disease will only progress, which in the future may cause serious complications.

Therapeutic regimens

The treatment regimen for Helicobacter pylori requires a comprehensive medical approach. Typically, the patient is prescribed 2 drugs that are selected individually. Plus, one agent from the group of proton pump inhibitors is necessarily prescribed.

The duration of treatment is determined by the gastroenterologist after a thorough examination of the patient and an assessment of the severity of the disease. The duration of the course of therapy is 14-21 days. After graduation, the doctor conducts repeated laboratory tests to confirm the complete recovery of the patient.

Antibiotics

Despite the fact that Helicobacter Pylori belongs to the group of pathogenic bacteria, not all antimicrobial drugs can destroy it.

The microorganism quickly develops resistance to antibacterial substances, which greatly complicates the healing process. Sometimes a doctor has to combine several drugs at once in order to achieve a positive dynamic, moreover, the acidic environment of the stomach can prevent the activation of the components of drugs and slow down the process of therapy.

Antibiotic therapy for helicobacteriosis involves the use of the following drugs:

  • Clarithromycin
  • cephalosporin preparations;
  • Azithromycin;
  • Levofloxacin.

The highest effect in the treatment of inflammation of the mucous membranes of the stomach and ulcers formed on it has Amoxicillin and its analog Flemoxin Solutab. It is possible to use other antibacterial drugs - Augmentin and Amoxiclav. They include clavulanic acid, which prevents the production of specific enzymes by microorganisms. This, in turn, prevents the development of resistance by the microorganism H. pylori.

Preparations of bismuth trikaliya dicitrate

Most often for the treatment of diseases caused by helicobacteriosis, the drug De-Nol is used, which includes the active ingredient tricalium dicitrate. Due to this, there is a significant reduction in the production of biological compounds that contribute to the growth and reproduction of pathogenic microflora.

De-Nol's action is aimed at:

  • disruption of cell membrane permeability;
  • changing cell membrane structure.

During the chemical interaction of tricalium dicitrate with protein compounds of the gastric mucosa, high-molecular complexes are formed. Due to this, a strong protective film is formed on the surface of the ulcers and erosion, which prevents the ingestion of gastric juice to the damaged areas of the gastric mucosa.

After completing the full course of treatment with De-Nol, an increase in the resistance of the gastrointestinal mucous membrane to pepsin and hydrochloric acid occurs.

Proton pump blockers

For effective and quicker disposal of Helicobacter Pylori, proton pump blockers are included in the treatment regimen. Due to the components included in their composition, complex biological processes are triggered, which lead to a decrease in the production of gastric hydrochloric acid.

The most effective proton pump inhibitors (inhibitors) include the following drugs:

  1. Omeprazole (Omez, Ultop).
  2. Rabeprazole (analogues - Hayrabesol, Beret).
  3. Pantoprazole (analogues - Kontrolok, Nolpaza).

With a decrease in gastric acidity, the process of repairing damaged tissues starts. It creates unfavorable conditions for the reproduction of pathogenic microorganisms, and in particular, H. pylori.

In addition, proton pump inhibitors significantly increase the effectiveness of antibiotics used to treat diseases caused by this bacterium. With this in mind, gastroenterologists often reduce the dose of antimicrobials. This favorably affects the state of the intestinal microflora and the general immunity of the patient.

Therapeutic diet

To normalize the work of the gastrointestinal tract during the entire course of treatment and after its termination, the patient must observe a special therapeutic diet. It implies the following rules:

  1. Food should be fractional, that is, you need to eat a little, but often.
  2. Exclude fried, fatty, spicy, spicy foods, pastry and confectionery.
  3. Follow the drinking regime.
  4. Refuse from alcohol and low alcohol beverages.
  5. Exclude from the diet marinades, pickles, sparkling water, fast food and other junk food.

At first, it will not be easy to follow such a strict diet, but while caring for your health, the patient must do this. Over time, he will get used to this diet, and will not notice the restrictions in food.

Here is a sample menu for patients with Helicobacter Pylori:

  1. Breakfast consists of oatmeal porridge, cheese curds from fresh cottage cheese and fruit compote.
  2. At lunch, it is allowed to eat cottage cheese souffle and drink a cup of chamomile tea.
  3. For lunch, you can eat soup based on chicken broth with lean meat, steamed fish cakes and steamed or fresh vegetables.
  4. On the second afternoon snack - fruit or milk jelly with baked apples.
  5. For dinner, you can eat steamed turkey and boiled potatoes.
  6. At late dinner it is allowed to eat kefir or decoction of rosehips.

Meals are selected individually, depending on the stage of the disease. It also takes into account the risk of exacerbations, as well as other factors.

Prevention

To avoid infection, you must follow the simplest rules:

  • wash hands thoroughly before eating, and also after visiting the restroom;
  • use only their own tools and hygiene items (towels, toothbrushes, soap, etc.);
  • completely cure pathology of the digestive tract;
  • to refuse from bad habits;
  • Be sure to undergo routine preventive medical examinations.

To consolidate the results of treatment and strengthen the immune system, the doctor will prescribe vitamin complexes, as well as drugs, which include the trace elements necessary for the person. But the patient himself should help his body grow stronger after the disease, giving up alcohol and smoking, and reviewing their lifestyle.

Watch the video: Treatment Paradigms for Resistant H. Pylori. Daniel Z. Uslan, MD. UCLA Digestive Disease (November 2019).

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