Helicobacter pylori infection overview
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Differentiating Helicobacter pylori infection from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Yamuna Kondapally, M.B.B.S[2]
Overview
Helicobacter pylori infection is a common worldwide human infectios. It is caused by H.pylori bacteria which is a gram negative, microaerophilic, and acidophilic bacterium that infects various areas stomach and duodenum. The infection is associated with number a number of upper gastrointestinal conditions like chronic gastritis, peptic ulcer disease, and gastric malignancy. It is more common in developing countries than developed countries. It is estimated that 30-40% of the US population are infected with H.pylori.
Historical Perspective
The association between helicobacter pylori and peptic ulcers was made by Barry Marshall and Ribin Warren in the year 1984 for which they were awarded with Nobel prize in 2005 in physiology or medicine.
Pathophysiology
Helicobacter pylori (H. pylori) is a bacterium that lives on the lining of the stomach. Although we used to think that spicy food, acid, and stress were the major causes of ulcers, we now know that nine out of ten ulcers are caused by H. pylori. Medicines that reduce stomach acid may make you feel better, but your ulcer may come back. Here's the good news: Since most ulcers are caused by this bacterial infection, they can be cured with the right antibiotics.
Causes
Helicobacter pylori infection is caused by H.pylori bacterium.
Epidemiology and Demographics
Approximately two-thirds of the world's population is infected with H. pylori. In the United States, H. pylori is more prevalent among older adults, African Americans, Hispanics, and lower socioeconomic groups.
Approximately 25 million Americans suffer from peptic ulcer disease at some point in their lifetime. Each year there are 500,000 to 850,000 new cases of peptic ulcer disease and more than one million ulcer-related hospitalizations.
Risk Factors
Common risk factors in the development of H.pylori infection are contaminated food and water, poor hygiene, over crowding, lower socio-economic status, smoking, age and race.
Screening
According to the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for H.pylori infection.
Treatment
Medical Therapy
Persons with active gastric or duodenal ulcers or documented history of ulcers should be tested for H. pylori, and if found to be infected, they should be treated. To date, there has been no conclusive evidence that treatment of H. pylori infection in patients with non-ulcer dyspepsia is warranted. Testing for and treatment of H. pylori infection are recommended following resection of early gastric cancer and for low-grade gastric MALT lymphoma. Retesting after treatment may be prudent for patients with bleeding or otherwise complicated peptic ulcer disease. Treatment recommendations for children have not been formulated. Pediatric patients who require extensive diagnostic work-ups for abdominal symptoms should be evaluated by a specialist.
Primary Prevention
Since the source of H. pylori is not yet known, recommendations for avoiding infection have not been made. In general, it is always wise for persons to wash hands thoroughly, to eat food that has been properly prepared, and to drink water from a safe, clean source.