Dr.. Muhammad Al-Khatib is a thoracic surgeon in Istanbul/Turkey - Bimaristan

Question 1

How do you know that you have infection of Helicobacter pylori?

Accepted Answer

The infection is acquired around 10 years of age and approximately 85% have long asymptomatic periods. Clinical manifestations are non-specific, and some may be justified by the presence of complications.

Question 2

What is the food that kills Helicobacter pylori?

Accepted Answer

H. pylori is able to overcome the stomach high acid content by means of virulence factors which enhance colonization of the gastric epithelium and induction of tissue damage.

Question 3

Is Helicobacter pylori excreted with feces?

Accepted Answer

One of the most common transmission routes of the bacterium is the fecal-oral route. Fecal-oral transmission has been verified indirectly from the results of South American studies. These studies showed that water supplies that may contain H. pylori and consumption of raw vegetables contaminated by human feces are significant risk factors for H. pylori infection.

Question 4

When H. pylori infection turn into cancer?

Accepted Answer

On the basis of compelling evidence, the World Health Organization (WHO) has classified H. pylori as a group 1 carcinogen leading to gastric adenocarcinoma. In addition to Japan, areas with an increased incidence of gastric carcinoma attributable to this infection include the Middle East, Southeast Asia, the Mediterranean, Eastern Europe, Central America, and South America.

The pathogenesis of gastric cancer includes a sequence of events that begins with H. pylori-induced chronic superficial gastritis, progressing towards atrophic gastritis, intestinal metaplasia, dysplasia and eventually gastric cancer. This sequence takes decades to complete.

Although H. pylori is now thought to account for 80% or more of gastric cancers, it is noteworthy that only 3% of infected patients progress to gastric cancer. This suggests that H. pylori infection only on its own is generally not sufficient to cause gastric carcinoma. A combination of bacterial factors, environmental insults, the host immune response and other genetic factors is responsible.

Question 5

How to protect yourself from H. pylori infection?

Accepted Answer

Prevalence rates ranging from 20-50% are reported in the adult populations of the developed world but the prevalence is much more in the developing countries with prevalence as high as 90% in some countries. Higher prevalence exists in regions of low socioeconomic and poor sanitary conditions, and in rural. The socioeconomic status of the family during childhood appears to be the major marker of infection.

A decline in prevalence has more to do with improvements in population hygiene and sanitation than with individual, case-by-case treatment. The prevalence of infection appears to be stable in countries in which standards have not improved or have deteriorated, and it is unlikely to fall substantially until improvements do occur.

Question 6

Is H. pylori infection transmitted through breathing?

Accepted Answer

H. pylori infection transmits from parents to children (oral-oral transmission is possible across individuals by infected saliva containing H. pylori).

Question 7

How long does it take to treat H. pylori infection?

Accepted Answer

The first-line option for H. pylori infection is represented by a standard triple therapy (STT) consisting of two antibiotics, clarithromycin and amoxicillin or metronidazole in combination with a proton pump inhibitor (PPI).

This combination was the first very widely recommended therapy and superseded less effective triple therapies. It has been very well evaluated over the years. The major determinant of eradication success with this combination is pretreatment clarithromycin resistance (CR). The optimal duration of therapy is a matter of contention. Recent calls for universal 14-day PPI-AC therapy usually originate from regions with higher CR. Initial studies were mostly for 7 days.

Author name: Dr.. Mohammed alkhatib

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