Ulcers and Helicobacter Pylori
~ by Jo Jordan
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It is estimated that twenty-five million Americans – nearly one in ten – will develop ulcers in her or his lifetime.1
Although ulcers are commonplace, and in spite of overwhelming evidence to the contrary that Helicobacter pylori (more commonly referred to as H. pylori) was a major player in the development of ulcers, until as recently as 1994 medical professionals insisted on perpetrating the myth that ulcers were caused by alcohol, spicy food, and stress.
Over a decade ago, this theory was proven to be completely false. Today, approximately twenty percent of Americans under forty, and half of those over sixty, are infected with H. pylori,2 and the link between the bacteria and ulcers has been clearly established.
Destroying the Long-held Medical Myth on the Cause of Ulcers
The bacteria H. pylori was first discovered in 1875 by German scientists.3
However, it was not until the 1980s when further studies on the bacteria by an Australian pathologist, Robin Warren, and his research partner, Barry Marshall that the medical world began to realize the error of its spicy-food-and-stress-causes-ulcers theory.
As part of an experiment that disproved this long-held misconception, Marshall – who along with Warren went on to win the 2005 Nobel Prize in Physiology or Medicine for their H. pylori research4 – ingested a dish of H. pylori, developed gastritis, determined that there was in fact H. pylori in the lining of his stomach, and then eventually cured himself with bismuth salts and the antibiotic metronidazole.
Up until very recently, as a result of the spicy-food-and-stress-causes-ulcers myth, ulcers were incorrectly and ineffectively treated with antacids.
But when – following in the footsteps of Warren and Marshall – the National Institutes of Health USA (NIH) published its statement in 1994 that most recurrent gastric ulcers were caused by H. pylori, the NIH recommended antibiotics be included in the treatment regimen for ulcers.
Signs, Symptoms, and Conditions Associated with H. Pylori Bacterial Infection
Most people who are infected with H. pylori experience very mild symptoms, or none at all. However, if you are suffering from an H. pylori-related illness, you may experience the following:
- An ache or burning pain in the abdomen
- Appetite changes with weight loss
- Bloody or black tarry stools
- Bloody vomit or vomit that looks like coffee grounds
- Frequent burping
Depending on the disorder that has developed, the signs and symptoms associated with H. pylori infection vary in duration and intensity.
While the reason for this is unknown, it has been suggested that genetic factors, along with the relative degree of harmfulness in different H. pylori strains, may make certain people more susceptible to the diseases and symptoms associated with H. pylori infection than others.
Disorders associated with H. pylori include,
- Gastric mucosa-associated lymphoid tissue (MALT) – the development of a cancerous tumor from white blood cells in the stomach’s lining
- Gastritis – an inflammation of the stomach's lining
- Nonulcer dyspepsia – stomach pain or discomfort not caused by an ulcer or other disorder associated with pain
- Stomach ulcers (also known as peptic ulcers, duodenal ulcers, or gastric ulcers) – open sores in the lining of the stomach or beginning of the small intestine / duodenum
- Stomach cancer – abnormal stomach cells divide uncontrollably
Without treatment, and once it takes up residence, H. pylori infection will be a constant in the life of its host’s intestine. Over time, an H. pylori infestation can lead to a chronic inflammatory response, damage the stomach’s lining, jeopardize vital acid-producing stomach glands, and put sufferers at risk for developing more serious diseases such as stomach cancer. It is crucial, therefore, to seek treatment.
Symptoms of an Ulcer5
Abdominal discomfort – the most common ulcer symptom – is reported as a dull, gnawing ache that comes and goes for several days or weeks, and that flares up two or three hours after a meal, or in the middle of the night.
While the ache can be relieved by eating as well as by ingesting antacid medications, the underlying H. pylori infection needs to be treated in order to resolve the ulcer.
As with an H. pylori infection, other symptoms of an ulcer include weight loss, poor appetite, bloating, burping, nausea, and vomiting.
If symptoms such as sharp, sudden, severe, persistent stomach pain; difficulty swallowing; a full or bloated sensation after a small meal; bloody or black tarry stools; or bloody vomit or vomit that looks like coffee grounds appear, it is crucial that a health care provider be contacted immediately.
What Causes Ulcers?
H. pylori bacterial infection is one cause, however, other causes include long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen sodium.
Cancerous tumors in the stomach and/or pancreas are believed to cause ulcers in some cases.
Causes of H. Pylori Infection
The exact means of contracting H. pylori is unknown, however, it is generally believed that the infection can be transmitted orally through the ingestion of fecal matter in tainted food or water.
Some researchers suggest that close person-to-person contact, such as exposure to vomit, is another way in which the bacteria passed along.
There is also some evidence to suggest that H. pylori – a contagious bacteria – is transmittable via mouth-to-mouth contact.
Diagnosing an H. Pylori-related Ulcer
When an ulcer is detected, health care providers test patients for H. pylori in order to determine the course of treatment. An ulcer caused by H. pylori is treated differently from one caused by a NSAID.
Blood, breath, stool, and tissue tests are used to diagnose H. pylori infection. A blood test reveals the presence of antibodies produced by the body to fight H. pylori bacteria.
Breath tests – which are highly accurate – can detect H. pylori by enabling the release of a tagged, radioactive carbon in urea solution drunk by the patient. H. pylori breaks down the urea, releasing the carbon which is then carried to the lung and exhaled. Breath tests are also used post H. pylori treatment to confirm the absence of the bacteria.
A stomach X-ray, or barium upper gastrointestinal series test, is used to examine the esophagus, stomach, and duodenum for anomalies. The ingestion of liquid (barium) prior to the X-ray coats the stomach lining to facilitate a clear X-ray view of the affected area. A gas-producing liquid or pill may also be used in order to stretch the stomach and separate its folds to provide a detailed image.
Stool tests detect infection by indicating H. pylori-related antigens in feces. Tissue tests use biopsied samples that have been removed with an endoscope to confirm the presence of specific enzymes produced by H. pylori, to find the actual bacteria, or to grow H. pylori culture in sample tissue.
Treating H. Pylori and Related Ulcers
Since the groundbreaking work of Nobel prize winners Warren and Marshall, ulcer patients in whom H. pylori infection has been confirmed are treated for one or two weeks using a combination of antibiotics, acid suppressors, and stomach protectors.
The antibiotics kill the H. pylori bacteria. Acid-suppressing drugs such as histamine-2 blockers are used to reduce the amount of hydrochloric acid released into the digestive tract, or proton pump inhibitors to suppress acids by shutting down the pumping process in acid-producing cells. A stomach-lining shield is also part of the treatment; it protects the lining of the stomach and duodenum.
The goal of this triple treatment therapy is to kill the H. pylori while allowing the ulcer to heal. Normally, a two-week course of the triple treatment therapy has a ninety percent efficacy rate6 for reducing ulcer symptoms, destroying H. pylori bacteria, and preventing the recurrence of ulcers.
Pharmaceutical drugs used to treat H. pylori-related ulcers include,
- Antibiotics: amoxicillin, clarithromycin, metronidazole, and tetracycline
- H2 blockers: cimetidine, famotidine, nizatidine, and ranitidine
- Proton pump inhibitors: esomeprazole, lansoprazole, omeprazole, pantoprozole, and rabeprazole
- Stomach-lining protector: bismuth subsalicylate (i.e. Pepto-Bismol)
While pharmaceutical drug therapy has proven to be extremely effective at eradicating H. pylori infections there is, of course, a downside. The negative effects of this type of treatment have inspired many to seek alternative and complementary therapies.
Alternative or complementary therapies used to treat H. pylori-related ulcers include
The triple therapy described above is difficult for some people to manage as it involves the daily ingestion of close to two-dozen pills.
Antibiotics can often cause unpleasant side effects such as diarrhea, dizziness, headaches, nausea, vomiting, and yeast infections (in women).
In addition, an increasing number of H. pylori-infected patients are turning up with bacteria that are resistant to antibiotic treatment. As a result, a great deal of research has been conducted – with more underway – regarding natural remedies for destroying H. pylori bacteria.
Researchers are particularly interested in the potential of probiotics to assist in cases where there are antibiotic-resistant bacteria in a patient’s gut.
Probiotic supplements have proven to be effective in reducing H. pylori-associated gastritis. Seven of nine human studies showed an improvement of H. pylori gastritis as well as a decrease in H. pylori density after the administration of probiotics.6
Sulforaphane is an anti-cancer and anti-microbial compound found in cruciferous vegetables such as kale, collard greens, broccoli, cauliflower, cabbage, and Brussel sprouts. With sulforaphane as one of the active agents in broccoli sprouts, consumption of this particular vegetable has shown to be effective at inhibiting H. pylori growth in some patients.7
H. Pylori Preventatives
Preventive strategies for H. pylori infection are the same as those used to protect against a variety of infections:
- Ensure hands are thoroughly washed with warm, soapy water after eating and/or using the toilet.
- Do not share glasses or utensils; H. pylori is believed to be transmitted via saliva.
- Avoid water or food that may have been contaminated by floodwater or sewage.
H. Pylori and Puristat
H. pylori infection is the most common cause of stomach ulcers.8 An extremely prevalent bacteria the world over, it also causes inflammation of the stomach lining, and may contribute to stomach and other digestive system cancers.9
While multiple-drug strategy therapies are effective, they are complicated and associated with numerous unpleasant side effects.
Puristat products offer alternative and complementary H. pylori and ulcer therapy.
Along with probiotic supplements, Puristat's Colon Cleanses - the formula for which includes probiotics - is a therapy advocated by alternative therapy professionals who believe that the symptoms of most digestive diseases can be relieved and/or alleviated with regular cleansing.
Since the presence of unwanted H. pylori bacteria is the major cause of uclers, colon cleansing and a colon cleanse diet may help to reduce the presence of unwanted bacteria, reducing stress on the nervous system and other organs, as well as lending support to the entire immune system.
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1. UCSF (University of California, San Francisco) Medical Center, “Ulcers,” http://www.ucsfhealth.org/adult/medical_services/gastro/ulcer/index.html (accessed April 30, 2008).
2. National Digestive Diseases Information (NDDIC), A service of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, “H. pylori and Peptic Ulcer,” http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/index.htm (accessed April 30, 2008).
3. Wikipedia, “Helicobacter pylori,” http://en.wikipedia.org/wiki/Helicobacter_pylori (accessed April 30, 2008).
4. Nobelprize.org, “The Nobel Prize in Physiology or Medicine 2005,” http://nobelprize.org/nobel_prizes/medicine/laureates/2005/press.html (accessed April 30, 2008).
5. National Digestive Diseases Information (NDDIC), A service of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, “H. pylori and Peptic Ulcer,” http://digestive.niddk.nih.gov/ddiseases/pubs/hpylori/index.htm (accessed April 30, 2008).
7. PubMed.gov, A service of the U.S. National Library of Medicine
and the National Institutes of Health, “The Nobel Prize in Physiology or Medicine 2005,” http://www.ncbi.nlm.nih.gov/pubmed/15387326 (accessed April 30, 2008).
8. Mayo Clinic.com, Tools for healthier lives, “Digestive System: H. pylori infection,” http://www.mayoclinic.com/health/h-pylori/DS00958 (accessed April 30, 2008).