Helicobacter pylori

What is H.pylori ?--
H.pylori is an organism that is non invasive & lives in the mucous that overlies the innermost layer of the stomach.

What does H.pylori cause ?--
H.pylori has been shown to play an important role in stomach ulcers & even a risk factor for development of some stomach cancers.
Here are results of some studies----

Presence of infection with H.pylori is an important risk factor for development of ulcers.

Cure of infection results in a dramatic decrease in the rate of ulcer relapse. (from about 80% to 15% in the first year.)

Experimental growth in animals does cause injury to stomach & duodenum.

What are the tests available to confirm the presence of H.pylori?--

Breath test-- this test is based on the fact that H.pylori metabolises urea.
Blood antibody detection.
Endoscopic biopsy--the biopsy specimen is tested for H.pylori. (CLO test to confirm the presence of urease)

How is the breath test done?
For the breath test the patient fasts for a few hours. He is given a solution of a marker 13C/14C-urea to drink. He then simply breaths into a tube at a predetermined time afterwards. If the organism is present, the urea is split by it; & it is then detected in the breath. The test is both simple & safe for the patient.

How sensitive are the tests?--
The biopsy test is 90% sensitive & the breath is 95% sensitive.

What is the treatment for the eradication of H.pylori?
In a case of stomach ulcers eradication of H.pylori is very important as it dramaticlly decreases the relapse rate of ulcers.
Various regimens are advocated for eradication of H.pylori -----

Bismuth subsalicylate, Tetracycline & Metranidazole for 2 weeks.

Omeprazole, Clarithromycin & Metronidazole for 1 week.

Omeprazole, Clarithromycin & Amoxicillin for 1 week.