The bacterium Helicobacter pylori was first demonstrated in the human stomach in 1983 by two Australian doctors. Later, it was proved that this bacterium is the most important cause of ulcer disease, breaking new ground in gastroenterology. Because; In the past, it was known that ulcer is a life-long disease and it progresses with exacerbations from time to time. However, we now know that the two most important causes of ulcer disease are Helicobacter pylori and aspirin and similar pain relievers for rheumatism. If the bacteria is treated and the patient does not use aspirin and similar pain relievers, the ulcer disease is completely eliminated.
The picture shows very magnified images of bacteria in the stomach with special microscopes.
In the following years, it has been shown that there is an important relationship between this bacterium and diseases such as gastritis, stomach cancer and gastric lymphoma. However, not everyone with bacteria in their stomach is a candidate for stomach cancer. Cancer development does not occur with a single factor. Many factors such as genetic predisposition, presence of bacteria, and malnutrition come together for the formation of cancer.
The proof of this important role of Helicobacter pylori in stomach diseases caused Marshall and Warren to be awarded the Nobel Prize in 2005, who showed this bacterium in the human stomach. This is also very important as it is the first Nobel Prize awarded in the field of gastroenterology.
What is the incidence of Helicobacter pylori?
The incidence of Helicobacter in societies is closely related to the socioeconomic status of that society. For example, while the rate of people infected with this bacterium is 20% in Australia, 30% in the USA, it is around 70% in our country. In some African countries, it can reach 100%. As the number of individuals living in the family increases, the probability of the bacteria being present in the individuals also increases.
How is Helicobacter pylorina transmitted?
It is not known exactly how the bacterium reached, but it is certain that the bacterium is transmitted through the mouth and this transmission is usually in childhood.
How to detect the presence of Helicobacter pylori?
The presence of bacteria can be easily detected in the biopsy taken from the stomach of the patient who underwent endoscopy. The presence of bacteria can be detected by breath or stool test in the patient who did not undergo endoscopy. While searching for bacteria with all these methods, it is necessary to make sure that the patient does not take drugs or antibiotics that reduce stomach acid. These drugs prevent the appearance of bacteria. Showing antibodies against this bacterium in blood or saliva tests does not indicate the presence of the bacterium. The antibodies shown by these tests show that the patient has encountered bacteria at any time in his life, and is not an indicator of the viability of the bacteria. Therefore, these tests should not be used in practice.
When should it be treated?
Ideally, it treats every patient carrying the bacteria. However, due to the prevalence of bacteria in our country, the low success rate in treatment, increasing antibiotic resistance and cost, patients who require absolute treatment are primarily treated. Patients with stomach or duodenum (duodenal) ulcers, who have had surgery for early gastric cancer or who have a first-degree relative with gastric cancer, and patients with cellular changes called metaplasia in the stomach should be treated. In other cases, individual decisions can be made.
How is it treated? Antibiotics are used in the treatment as in every bacteria. However, since Helicobacter pylori is difficult to treat, two antibiotics are used together in the treatment and a drug that reduces stomach acid is added to the treatment. Reducing stomach acid increases the effect of antibiotics. The course of treatment should be 10-14 days. Antibiotics may have some side effects during this treatment. Therefore, if possible, drugs should not be discontinued. Because such a situation may complicate the treatment of the bacteria in the second attempt.
Does it recur after treatment?
When an effective treatment is applied, the bacteria is cured with a probability of 80-90%. The probability of the bacteria being seen again in the stomach is very low. Unfortunately, the probability of treating this bacterium in our country has decreased to 50-65% today. The reason for this is the indiscriminate use of antibiotics in our society and the repeated use of the same antibiotics in treatment. If bacteria cannot be treated with a combination of antibiotics, the same combination should not be used for retreatment.
