What is and what causes helicobacter pylori?
For many years we thought that the stomach was a sterile organ and that due to the amount of acid did not develop germs or bacteria or viruses, but in the 80s two Australian gastroenterologists discovered a bacterium in the stomach and by that discovery they obtained the Nobel Prize. Now we know that in the stomach there is the helicobacter pylori, which is a germ, a large flagellated negative, that moves and that grows with temperatures of 37 degrees Celsius.
This produces an inflammatory response in the gastric mucosa and leads to acute gastritis. This acute gastritis can develop a chronic gastritis and duodenal ulcer or an atrophic gastritis and gastric ulcer. If there is also intestinal metaplasia or dysplasia, gastric cancer may develop.
It must be said that more than 50% of the population suffers helicobacter pylori, some people are carriers and others develop these diseases that we have said and is also related to iron deficiency anemia and thrombocytopenic purpura.
What are the main symptoms reported by patients?
The symptomatology of helicobacter pylori is quite nonspecific. While it is true that sometimes, especially in acute gastritis, causes severe pain, epigastralgia, which require us to perform an ultrasound to rule out abdominal pathology. While it is true that most patients have burning and dyspepsia and only sometimes weight loss and vomiting, which are symptoms of alarm, will force us to perform an endoscopy.
Could you describe what the diagnostic test consists of?
Diagnosis can be made with invasive or non-invasive methods. Among the invasive methods is endoscopy, the gastroscopy that takes samples from the stomach for the helicobacter pylori.. Both the biopsy and the culture have a very high sensitivity and specificity. Among the non-invasive methods we have the breath test that is performed with the equipment that we see here. And other alternative methods are serology or the determination of helicobacter pylori in saliva or feces.
Is the treatment the same for all patients, what is it?
The treatment should not be indiscriminate and should not be treated to the carriers, should treat every patient with a disease related to helicobacter pylori. The therapy of first choice is the triple therapy that associates an antisecretory with antibiotics. In patients who are allergic to penicillin we will use clarithomycin and metrodiazole. The eradication with these guidelines and with alternative guidelines produces 80-90% eradication of helicobacter pylori, which has achieved a decrease in the incidence of gastric cancer and increase other diseases such as reflux disease due to hiatal hernia.
Should the food be retrieved?
Not at the beginning. A varied and normal diet should be made. Keep in mind that this is an infectious disease and not food. Finally, I would like to read a few lines from a recent review that says: "The current trend seems to be aimed at better detection of helicobacter pylori infections. To the specific treatment of the diseases caused by this bacterium avoiding treatments of indiscriminate eradication and to the development of prophylactic measures, vaccines included that are in experimental phase, that avoid or delay the infection by virulent strains of helicobacter pylori ".