Helicobacter pylori (abbreviated as H. pylori, also known by its former name Campylobacter pylori) is a bacterium that was discovered relatively late. Helicobacter pylori is primarily located in the distal portion of the stomach, referred to as the pylorus (Latin for “pylorus,” hence the second part of the bacterium's name), which empties into the duodenum. H. pylori can also infect other tissues.
Scientists have found that the bacterium occurs in people with chronic gastritis and stomach ulcers. It was a big surprise to discover that there is a bacterium adapted to survive in the human stomach because until it was assumed that the stomach's hydrochloric acid creates an environment that is hostile to bacteria – it simply disinfects food, which is one of its main physiological tasks. In the case of Helicobacter pylori, however, it was observed that it colonizes mucous membranes with a low pH (acidic reaction). Not only did the acid not harm the bacterium, but it seemed necessary for its development.
In the course of further scientific research, it was found that there is a link between the presence of Helicobacter pylori in the upper digestive tract and stomach and duodenal ulcers. Nevertheless, remember that the condition with the bacterium itself is not comparable to the development of peptic ulcer illness. Almost half of humanity (more in developing countries) is infected with Helicobacter pylori.
The disease usually happens in childhood. Infection occurs through the digestive tract, e.g., by sharing dishes or drinking from the same bottle. The old rule that there is no peptic ulcer without acid remains valid. However, the risk of the disease increases dramatically in people infected with Helicobacter pylori (or who are its carriers).
A stomach ulcer is a precancerous condition, which is why Helicobacter pylori infection can promote the development of stomach cancer. Overall, H. pylori infection almost doubles the total risk of stomach cancer.
On the other hand, cancer usually does not develop in the duodenum. The reasons are not entirely clear, but in the epidemiology of the human digestive tract, colon and rectal cancer, stomach cancer and esophageal cancer are common, while small intestine cancer (including duodenal cancer) is rare. So while Helicobacter pylori infection promotes gastric and duodenal ulcers and, to a lesser extent, stomach cancer, it does not pose a risk of duodenal cancer, which practically never happens.
Symptoms of Helicobacter pylori infection may but do not necessarily have to occur. In practice, the infection is often asymptomatic for a long time. Signs to look out for include:
The most common symptoms are similar to poisoning or other digestive problems. However, Helicobacter pylori most often travels through the oral cavity and only then reaches the stomach. It leads to an unpleasant smell and taste in the mouth that may also be symptoms of infection with this bacteria. It can occur throughout the oral cavity, both on the tongue and dental plaque.
Some sick people have also reported increased hair loss. This may be caused by a general weakening of the body by the bacteria or its direct effect on substances needed for hair production.
In the case of an asymptomatic course of Helicobacter pylori, the confirmation of its presence in the body is the result of a laboratory test or an endoscopic or astrological examination.
H. pylori seriously affects well-being. Even when the symptoms do not interfere with everyday life, their constant occurrence makes a person tired. Studies have also been conducted that have shown that infection with this bacterium affects the reduction of serotonin production (the happiness hormone). Therefore, depression may appear.
The gastric mucosa cells create hydrochloric acid and digestion of food in the stomach takes place in low pH conditions, though they are not immune to the consequences of acid. Consequently, under normal circumstances, they are coated with a thin coating of protective mucus. Non-steroidal anti-inflammatory medications, such as acetylsalicylic acid, impair the gastric mucosa and lead to the development of ulcers, among other things because they inhibit the synthesis of prostaglandins, which trigger the mucus production in the stomach.
The bacterium may acclimate to the local requirements in the stomach, especially in the pylorus. It bypasses places with extremely low pH, and therefore the stomach lumen, away from its wall. Instead, it migrates towards the cells of the stomach wall (mucosal epithelium), where it penetrates the layer of mucus covering the cells.
In individuals who secrete more extensive portions of hydrochloric acid, the bacteria more readily occupy the pylorus, particularly where the stomach passes into the duodenum. In this way, it avoids the body of the stomach, where the pH is low (highly acidic). When the secretion of hydrochloric acid is lower, Helicobacter pylori colonizes the entire stomach.
The movement of the bacteria is active, occurring thanks to its characteristic shape and the presence of flagella. Helicobacter pylori then adhere to epithelial cells and even penetrates them. An essential element distinguishing the consequences of Helicobacter pylori infection is how the immune system reacts to the bacteria.
Another known toxic consequence of Helicobacter pylori metabolism is ammonia. It is a fragile base, so it serves the bacteria to balance hydrochloric acid in its immediate environment and promotes its survival. It is produced from urea, and the enzyme used by Helicobacter pylori is called “urease” (from the Latin word urea, meaning urea). Urease breaks down urea into carbon dioxide and ammonia. The activity of urease secreted by Helicobacter pylori is the basis of a significant test for detecting this bacterium.
As for the causes of gastric cancer, it is assumed that bacteria themselves do not induce modifications leading to cancer but rather stimulate a local inflammatory response, the typical features of which are white blood cell infiltrates and local production of DNA-damaging free radicals. These act locally, initiating the development of cancer cells.
Another postulated mechanism results from the death of epithelial cells damaged by Helicobacter pylori. The gaps are filled by replacing these cells with new, dividing cells from the reserve pool of the epithelium. As a result, mutated (potentially cancerous) cells can enter the division cycle. Therefore, the simultaneous chronic inflammatory reaction caused by virulent strains of bacteria and accumulating mutations of dividing cells is dangerous.
To sum up: according to the current state of knowledge, there is a relationship between infection of the digestive tract by Helicobacter pylori and stomach cancer. The bacterium does not directly cause mutations in human DNA leading to the development of cancer but promotes them by maintaining a chronic inflammatory state. It is therefore a so-called promoter of carcinogenesis. Carcinogenesis then occurs in the stomach on the basis of a peptic ulcer or chronic inflammatory reaction.
In H. pylori diagnostics, invasive and non-invasive methods are used.
Invasive methods (requiring endoscopy) include:
For at least 4 weeks before the following tests (except serological tests), you should not take antibiotics or bismuth preparations, and proton pump inhibitors (PPIs) for 2 weeks.
In such a situation, the doctor will implement the so-called eradication treatment. Therefore, the treatment is generally supposed to be long-term, and radical and lead to the removal of the entire reservoir of Helicobacter pylori from the patient's digestive tract.
Eradication treatment involves the use of a so-called antibacterial treatment regimen, i.e., taking several drugs for a specified period of time. All regimens incorporate the use of a drug that inhibits the secretion of hydrochloric acid in the stomach (drugs from the group of proton pump inhibitors, or IPPs, are used).
Helicobacter pylori treatment, known as eradication, is a key element of therapy for many diseases of the upper gastrointestinal tract, including gastric and duodenal ulcers, gastritis, and some cancers. Treatment aims to remove the bacteria from the body, which helps in the treatment of the aforementioned diseases and prevents their complications.
The choice of treatment regimen for Helicobacter pylori infection depends on individual factors – including the patient's treatment history and the sensitivity of the bacteria to antibiotics.
Helicobacter pylori is a bacterium that spreads from person to person. It commonly lives in the stomach and duodenum. If left untreated, it may lead to ulcers and even stomach cancer in predisposed individuals.
Helicobacter pylori does not cause weight gain, on the contrary – it can cause weight loss. It is good to mention that the infection can coexist with other diseases. In such a case, basic laboratory and imaging tests should be performed.
In the case of Helicobacter pylori infection, diet is an extremely important element supporting therapy. Eating properly selected foods can alleviate symptoms and speed up recovery. Below, we will describe the regulations of the diet for Helicobacter pylori infection.
Follow the rules (always remember to consult them with a specialist):
You can eat:
Additionally, some of those foods can slow down digestion, increase acidity, and irritate the stomach, feed harmful bacteria, causing symptoms to worsen and increasing the risk of complications.
Duting helicobacter pylitri infection you shouldn't eat:
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