Introduction
Genus Helicobacter
In 1983,
Warren and Marshal suggested that gastritis and peptic ulcers were infectious
diseases, contradicting the long-held beliefs and dogma that bacteria could not
colonize the stomach. Helicobacter is a type Spiral-shaped gram negative,
microaerophilic, motile rods with polar flagella. Nearly 20 species Helicobacter are now
recognized. One group, the gastric
helicobacters, colonize stomach the other, the enterohepatic group colonize the
intestine and liver.
Species of medical importance
Helicobacter pylori
Infection
with H. pylori (formerly Campylobacter pylori) is widespread. Transmission is by person to person contact,
and probably also by contaminated water and food. H. pylori is thought to be the cause of most
gastric and duodenal ulcers. In
developing countries, H. pylori may also contribute to diarrhea, malnutrition
and growth failure in young children (reduced gastric acid protection leads to
infection with entero pathogens). Pylori is a type of bacteria. These germs can
enter can your body live in your digestive tract after many years, they can
cause sores, called ulcers, in the lining of your stomach or upper part of your small intestine. However, many people never experience
symptoms or complications from it and they live with the bacteria for years
without even knowing they have it but for some people, this bacteria can lead
to significant health issues such as peptic ulcers, chronic gastritis, or even
stomach cancer. It’s estimated that about 20-30% of people infected symptoms.
Haw to transmitted helicobacter pylori
The most
common mode of transmission is thought to be person to person, either through
oral-oral or fecal-oral route. This means the bacteria can be passed through
saliva, vomit, or fecal matter of an infected person. This can happen via close
contact, such as kissing, or through shared utensils. Another potential route
of transmission is through contaminated food or water in areas with inadequate
sanitation, Pylori can contaminate the water supply, leading to widespread
infection. Some studies have also suggested that the bacteria might be
transmitted through raw or undercooked foods.
Pathogenesis and clinical manifestations
Multiple factors can contribute to the gastric
inflammation, alteration of gastric acid production and others. Initial colonization is facilitated by
blockage of acid production by a bacterial acid – inhibitory protein and
neutralization of gastric acids by the ammonia produced by bacterial urease
activity. The actively motile
Helicobacter can then pass through gastric mucus and adhere to the epithelial
cells. Localized tissue damage is mediated by urease by products, mucinase,
phospholipase and the activity of vaculating cytotoxin that induce epithelial
cell damage.
Diseases caused by H. pylori
- Peptic ulceration-gastritis and hyper acidity.
- Non -ulcer dyspepsia.
- Gastric cancer – gastric MALT lymphoma.
- Others – coronary heart disease and iron deficiency anemia.
Laboratory diagnosis of Pylori
Specimen: Gatric biopsy and serum Place a
biopsy of mucosa from the gastric antrum in a bottle containing about 0.5 ml of
sterile physiological saline. Smear: Giemsa’s or silver stain H. pylori
appears as a small (2-6.5 µm long) spiral or S-shaped Gram negative bacterium.
The organism can also be stained using Giemsa’s stain. Culture:
Isolation of H. pylori may occasionally be required in the investigation of
gastric disease. Chocolate (heated blood) agar or Campylobacter medium.
Christensens urea broth. On Skirrow’s media
- translucent colonies after 7 days of incubation. Serology: Detection of antibodies in the serum specific
for H. pylori. Detection of H. pylori
antigen in stool specimen. Urease breath test: This non-microbiology
test may be performed in specialist gastroenterology centres. The patient
ingests 13C or 14C radio-labelled urea. Any carbon dioxide produced by urease
producing H. pylori is detected in the breath using a mass spectrometer or a
scintillation counter.
Haw to
treatment Pylori
Triple or
quadruple therapy:
Amoxicillin plus clarithromycin/ metronidazole plus Proton pump inhibitors
(PPI), Omeprazole or lansoprazole, or Metronidazole plus Bismuth subsalicylate/
Bismuth subcitrate + Amoxicillin / Tetracycline plus PPI.
Haw to prevention H. pylori
While
there’s no vaccine to prevent Pylori infection, you can take several measures
to reduce your risk of contracting the bacteria. Practicing good hygiene is
crucial here. This includes washing hands thoroughly with soup and water especially
before eating and after using the bathroom. In areas where water safety is a
concern, drinking water from safe sources is essential. This mean using bottled
water or boiling water before consumption.
Conclusion
Helicobacter pylori is a spiral-shaped bacterium that
colonizes the human stomach and is strongly linked to chronic gastritis, peptic
ulcers, and an increased risk of gastric cancer. Its ability to survive in the
acidic environment of the stomach makes it a significant human pathogen. Early
diagnosis and appropriate treatment with antibiotics and acid-suppressing
therapy are essential to prevent complications. Effective control of H. pylori
infection not only improves digestive health but also reduces the global burden
of gastric diseases.
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