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Helicobacter pylori
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{{Stub}} '''''Helicobacter pylori''''', or '''''H. pylori''''', previously known as '''''Campylobacter pylori''''', is a Gram-negative, [[microaerophilic bacterium]] usually found in the stomach. It was identified in 1982 by [[Australia|Australian]] scientists Barry Marshall and Robin Warren, who found that it was present in a person with chronic [[gastritis]] and [[gastric ulcers]], conditions not previously believed to have a microbial cause.<ref>{{Cite journal | last = Marshall | first = Barry J | author-link = | last2 = Warren | first2 = J. Robin | date = Jun 1984 | title = UNIDENTIFIED CURVED BACILLI IN THE STOMACH OF PATIENTS WITH GASTRITIS AND PEPTIC ULCERATION | url = https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(84)91816-6/fulltext|journal=The Lancet|volume=|issue= | pages = |quote=|via=}}</ref> It is also linked to the development of [[duodenal ulcers]] and [[stomach cancer]]. However, over 80% of individuals infected with the [[Bacteria|bacterium]] are asymptomatic, and it may play an important role in the natural stomach ecology.<ref>{{Cite journal | last = Blaser | first = Martin J | date = Oct 2006 | title = Who are we? Indigenous microbes and the ecology of human diseases | url = https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1618379/|journal=EMBO Reports|volume=7|issue=10 | pages = 956–960|doi=10.1038/sj.embor.7400812|issn=1469-221X|pmc=1618379|pmid=17016449|quote=|via=}}</ref> More than 50% of the world's population has ''H. pylori'' in their upper [[Gastrointestinal|gastrointestinal tracts]].<ref>{{Cite journal | last = Amieva | first = Manuel | last2 = Peek | first2 = Richard M. | date = Jan 2016 | title = Pathobiology of Helicobacter pylori-induced Gastric Cancer |url =https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4691563/|journal=Gastroenterology|volume=150|issue=1 | pages = 64–78|doi=10.1053/j.gastro.2015.09.004|issn=0016-5085|pmc=4691563|pmid=26385073|quote=|via=}}</ref> It was once thought stress and diet caused [[Peptic ulcer|peptic ulcers]] but is now known they are due to ''H. pylori''.<ref>{{Cite web | url=https://www.verywellhealth.com/causes-of-peptics-ulcers-1741791 | title = Do You Know What Causes Peptic Ulcers? | last = Gillson | first = Sharon | authorlink= | date = Jul 3, 2018 | website = Verywell Health|language=en|archive-url=|archive-date=|url-status=|access-date=2019-03-30}}</ref> The [[biopsychosocial model]] was [[Biopsychosocial model#Criticism|once applied to peptic ulcers]]. Davey Smith states that peptic ulcer was "the classic BPS disease" but that "[[Cognitive behavioral therapy|cognitive behavioural therapy]] rather disturbingly had no effect"; only the discovery of ''helicobacter pylori'' in 1983 allowed the patients to be cured.<ref>{{Cite book | url = https://books.google.com.ua/books?hl=en&lr=&id=chwtWAt76JoC&oi=fnd&pg=PR15&redir_esc=y#v=onepage&q&f=false | title = Biopsychosocial Medicine: An Integrated Approach to Understanding Illness | last = White | first = Peter | last2 = Davey Smith | first2 = George | date = 2005| publisher = Oxford University Press|isbn=9780198530343|editor-link=|location= | pages = |language=en|chapter=5|quote=|editor-last2 = |editor-link2 = }}</ref> == Testing == ===Urea breath test (UBT) === * During the test, you swallow a special substance that has urea. Urea is a waste product the body produces as it breaks down protein. The urea used in the test has been made harmlessly radioactive. * If'' H. pylori'' are present, the bacteria convert the urea into carbon dioxide, which is detected and recorded in your exhaled breath after 10 minutes. * This test can identify almost all people who have ''H. pylori''. It can also be used to check that the infection has been fully treated.<ref name=":1" /> ==== What you cannot take prior to the Urea breath test ==== * FAST for at least one hour before the test. This means that you consume no food and drink only water prior to the test. * Phenylketonuric patients should avoid the test. Active ingredient is mixed with aspartame and contains 84 mg phenylalanine per dosage unit. (For reference, 12 ounces of typical diet cola soft drinks contain approximately 80mg of phenylalanine). * Avoid [[proton pump inhibitor]]s including Prilosec, Prevacid, Nexium, Protonix, Aciphex, and Dexilant within two weeks prior to the urea breath test. * Avoid antibiotics two weeks prior to the urea breath test. * Avoid bismuth preparations (Pepto Bismol) within two weeks of the urea breath test. * Do not test before four weeks after ''H. pylori'' treatment.<ref name=":0">{{Cite web | url=https://www.metsol.com/hydrogen-breath-test/healthcare-providers/ubt/urea-breath-test-preparation/ | title = How to Prepare for the Urea Breath Test {{!}} Gut-Chek|website=Stable Isotope Analysis Services {{!}} Metabolic Solutions|language=en-US|access-date=2019-03-30}}</ref> ==== What you can take prior to the Urea breath test ==== * Prior to testing, the patient may take H2 antagonists (Tagamet, Zantac, Pepcid, Axid) or Antacids (Tums, Rolaids, Maalox).<ref name=":0" /> === Blood tests === You do not have to do anything prior to the blood test.<ref>{{Cite web | url=https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw1531#hw1546 | title = Helicobacter Pylori Tests | last = | first = | authorlink = | date = | website = wa.kaiserpermanente.org|at=How To Prepare - Blood antibody test|archive-url=|archive-date=|url-status=|access-date=2019-03-30}}</ref> * Blood tests are used to measure antibodies to ''H. pylori''. Antibodies are proteins made by the body's immune system when it detects harmful substances such as bacteria. * Blood tests for ''H. pylori'' can only tell if your body has ''H. pylori'' antibodies. It cannot tell if you have a current infection or how long you have had it. This is because the test can be positive for years, even if the infection is cured. As a result, blood tests cannot be used to see if the infection has been cured after treatment.<ref name=":1">{{Cite web | url=https://medlineplus.gov/ency/article/007501.htm | title = Tests for H. pylori: MedlinePlus Medical Encyclopedia|website=medlineplus.gov|language=en|access-date=2019-03-30}}</ref> === Stool tests === * A stool test can detect traces of ''H. pylori'' in the feces. * This test can be used to diagnose the infection and confirm that it has been cured after treatment.<ref name=":1" /> ==== What you cannot take prior to the stool test ==== Some medicines can change the results of the test. Inform your doctor about all your prescription and nonpresecription medications you are taking.<ref name=":3">{{Cite web | url=https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw1531#hw1546 | title = Helicobacter Pylori Tests | last = | first = | authorlink = | date = | website = wa.kaiserpermanente.org|at=How To Prepare - Stool antigen test|archive-url=|archive-date=|url-status=|access-date=2019-03-30}}</ref> * Do not take antibiotics or medicines containing bismuth (such as Pepto-Bismol) for 1 month before the test. * Do not take proton pump inhibitors (such as Nexium or Prilosec) for 2 weeks before the test.<ref name=":3" /> === Biopsy === * A tissue sample, called a biopsy, is taken from the stomach lining. This is the most accurate way to tell if you have an ''H. pylori'' infection. * To remove the tissue sample, you have a procedure called endoscopy. The procedure is done in the hospital or outpatient center. * Usually, a biopsy is done if endoscopy is needed for other reasons. Reasons include diagnosing the ulcer, treating bleeding, or making sure there is no cancer.<ref name=":1" /> ==== What you cannot take prior to a biopsy ==== Many medications may change the results of your test. Inform your doctor of all prescription and nonprescription medications you are taking.<ref name=":4">{{Cite web | url=https://wa.kaiserpermanente.org/kbase/topic.jhtml?docId=hw1531#hw1546 | title = Helicobacter Pylori Tests | last = | first = | authorlink = | date = | website = wa.kaiserpermanente.org|at=How To Prepare - Stomach biopsy or urea test|archive-url=|archive-date=|url-status=|access-date=2019-03-30}}</ref> * Do not take antibiotics or medicines containing bismuth (such as Pepto-Bismol) for 1 month before the test. * Do not take proton pump inhibitors for 2 weeks before the test. * Do not take H2 blockers, such as Pepcid, Zantac, Axid, or Tagamet, for 24 hours before the test.<ref name=":4" /> == Treatment == Treatment could mean taking 14 or more pills per day for weeks. Antibiotics must be taken the right way or bacteria in your body could become resistant to them.<ref name=":2">{{Cite web | url=https://www.webmd.com/digestive-disorders/h-pylori-helicobacter-pylori | title = H. pylori: Causes, Symptoms, Treatment|website=WebMD|language=en|access-date=2019-03-30}}</ref> Antibiotics are used to kill the bacteria, usually two, as well as bismuth subsalicyate. Drugs that reduce the amount of acid in your stomach may also be taken. Medicines that block the chemical [[histamine]], which prompts your stomach to produce more acid.<ref name=":2" /> 1-2 weeks after you finish your treatment, your doctor may test your breath or stool again to make sure the infection is gone.<ref name=":2" /> == Prevention == * Wash your hands after you use the bathroom and before you prepare or eat food. Teach your children to do the same. * Avoid food or water that’s not clean. * Don’t eat anything that isn’t cooked thoroughly. * Avoid food served by people who haven’t washed their hands.<ref name=":2" /> Stress, spicy food, alcohol, and smoking may prevent ulcers from healing.<ref name=":2" /> == See also == * [[Biopsychosocial model]] == Learn more == * [https://www.youtube.com/watch?v=DYzYLTRASRM Helicobacter pylori (H.pylori) Simplified]<ref>{{Cite web | url=https://www.youtube.com/watch?v=DYzYLTRASRM | title = Helicobacter pylori (H.pylori) Simplified | last = Choi | first = Paul M. | authorlink = | date = | website = YouTube| publisher = Los Angeles Colonoscopy|archive-url=|archive-date=|url-status=|access-date=}}</ref> (Video) == References == {{reflist}} [[Category: Bacteria]]
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