Helicobacter pylori (H. pylori) is a gram-negative bacterium identified as a major culprit of multiple gastrointestinal disorders. It is a helically structured bacterium that colonises the human stomach and upper gastrointestinal tract. Infection with H. pylori is deemed a macro health problem and affects a substantial percentage of the global populace.

Infection with H. pylori is correlated to the development of chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and mucosa-associated lymphoid tissue (MALT) lymphoma. Chronic gastritis is an inflammation of the stomach lining and is the most common disorder accompanying H. pylori infection. This bacterium has a unique ability to endure the acidic environment of the stomach by producing urease, an enzyme catalysing the conversion of urea into ammonia, nullifying the acid in its immediate surroundings.

Peptic ulcer disease is another condition linked with H. pylori infection. It is characterised by a split in the mucosal lining of the stomach or duodenum, causing abdominal discomfort, nausea, and vomiting. Furthermore, H. pylori is strongly associated with the formation of gastric adenocarcinoma, a type of cancer concerning the lining of the stomach. This is due to the constant inflammation caused by the bacterium, leading to genetic changes potentially resulting in abnormal cellular growth.

MALT lymphoma is a rare type of non-Hodgkin’s lymphoma that arises from the mucosa-associated lymphoid tissue in the stomach. It has been linked to H. pylori infection, and eradication of the bacterium can result in complete remission of the lymphoma.

Diagnosis of H. pylori infection can be done through several means, including urea breath tests, stool antigen tests, and biopsy-based tests. Urea breath tests involve the patient ingesting a labelled urea substrate metabolised by the H. pylori enzyme urease. The labelled carbon dioxide produced by this reaction can then be detected in the patient’s breath. Stool antigen tests and biopsy-based tests involve the revelation of H. pylori antigens or genetic material in the stool or tissue samples, respectively.

Treatment for H. pylori infection typically consists of a combination of antibiotics and acid-suppressive therapy. The aim of treatment is to annihilate the bacteria present and prevent the manifestation of associated conditions. Antibiotics utilised to treat H. pylori infection include amoxicillin, clarithromycin, metronidazole, and tetracycline. Acid suppressive therapy, such as proton pump inhibitors and histamine-2 receptor antagonists, are employed to reduce the acidity of the stomach, thus improving the effectiveness of the antibiotics.

In conclusion, H. pylori infection is a noteworthy international health crisis and is associated with a range of gastrointestinal disorders, including chronic gastritis, peptic ulcer disease, gastric adenocarcinoma, and MALT lymphoma. Diagnosis of H. pylori infection can be done through various methods, and treatment involves a combination of antibiotics and acid-suppressive therapy. Early recognition and treatment of H. pylori infection can thwart the development of associated conditions and improve patient outcomes.

Article Credits
Dr. Anoop Lal, Medical Director, CareMithra
Rohan Panicker, Creative Writer, CareMithra