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Facts you need to know about H pylori

Eating spicy foods. Photo/Courtesy

Evelyne Makena

Eating spicy foods and having psychological stress are two factors thought to lead to ulcers. But findings by two Australian scientists back in the 1980s point to a less known culprit; a bacterium called Helicobacter (H) pylori.

A lot of people think they have basic indigestion, or unexplained loss of appetite when what they really have is H pylori. Here are some facts to note for those unknowingly struggling with the bacteria:

1. Caused by a bacterium

H pylori is a bacterium that affects the inner lining of the stomach. The bacterium is found in half of the world’s population, but many people don’t realise they have it since they do not manifest any signs or symptoms.

Though it’s not clear why it affects only a proportion of people, some people are thought to have a higher resistance to the harmful effects of H pylori.

2. Infections occur during childhood

Most infections occur during childhood and last a lifetime if not treated. Risks of contracting H pylori are related to living conditions during childhood. Living in crowded places increases the risk of the infection.

Not having a reliable source of clean water and living with someone with H pylori bacteria also increase the risk of the infection.

Notably, people living in developing countries with crowding and unsanitary conditions face a higher risk of getting the infection.

3. Symptoms of the  infection

Not everyone with H pylori bacteria will manifest its symptoms. When the symptoms occur, they may cause a lot of discomfort and sometimes go undiagnosed or misdiagnosed for long periods of time.

The symptoms include persistent bloating, loss of appetite, nausea, abdominal pains, burning pain in the abdomen, unintentional weight loss and frequent burping.

Other symptoms of the infection include bloody or black stool and vomit, difficulty swallowing and extreme abdominal pain.

H pylori infection is done through endoscopy, blood, stool and breathe tests.

4. Higher chances of developing peptic ulcers

People with H pylori infection have increased risk of developing ulcers. About 10 to 15 per cent of people with H pylori develop peptide ulcers as a result of the damaging effects of the bacteria on the protective lining of the stomach and small intestines.

The infection can also irritate the stomach and cause gastritis—inflammation of the stomach lining.

Gastritis manifests symptoms similar to those of ulcers including stomach pain, nausea and vomiting.

5. The spread

Even though the exact way H Pylori infects individuals is still unknown, the bacteria can be spread through direct contact with vomit, saliva or foecal matter of an infected person.

It may also be spread through food that is not washed or cooked properly. Someone can also get it from drinking unclean water.

6. Prevalence highest in Africa

A global review by the American Gastroenterological Association (ASA) found that in 2015 approximately 4.4 million people worldwide had H pylori with the prevalence being highest in Africa.

Based on the review, eight out of 10 people in Africa have H pylori. The high prevalence rates in Africa were associated to factors such as sanitation, access to clean water and level of urbanisation.

Across the world, H pylori is considered a major public health concern.

7. Link to cancer

The infection is a major cause of stomach (gastric) cancer. According to ASA up to 89 per cent of all gastric cancers are attributable to H pylori infection.

Though it’s one of the common cancers in the world, prognosis of gastric cancer is poor with only one in five patients surviving after diagnosis.

Interestingly, despite the high H pylori prevalence in Africa, the incidence of gastric cancer was relatively lower compared to China and Japan. Eradication of H pylori has been linked to reduction of gastric cancer incidences.

8. Vaccine

After several failed attempts to develop a H pylori vaccine one oral vaccine in China has given promising results of its effectiveness to reduce H pylori risk spread among young people.

Although the vaccine reduces the risk of contracting the H pylori over a period of three years, there is no proof yet on whether it can protect against H pylori related disease in the long term.

Given the high global H pylori prevalence, research is still ongoing on creating an effective vaccine.

9. Prevention

Even though the exact cause of H pylori is not known, there are few recommendations on how to avoid infection.

To lower the risk of the infection, it is advisable to properly wash hands or use a hand sanitiser, drink water from a clean and safe source and eat food that is properly prepared.

As a precautionary measure, you may go for a H pylori screening if you think you have a high risk of the infection.

10. Treatment

Doctors prescribe a combination of antibiotics to help prevent the bacteria from developing resistance to one antibiotic.

In addition to the antibiotics, doctors prescribe a drug to help reduce acid and heal the stomach lining.

There are other natural H pylori treatments, which reduce the amount of bacteria, but do not completely eradicate them. Probiotics, honey, olive oil, broccoli sprouts are some of the natural remedies.

Doctor’s approval must be sought before replacing the recommended treatment with natural remedies.

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