So what Exactly is the Cause of Your Stomach Issues? Perhaps, it’s H. Pylori

Written by Christine Bishara MD

It was 1982 when Dr. Barry Marshall, an Australian gastroenterologist, started to notice a peculiar finding in some of his patients. A large portion of his gastritis and ulcer patients showed the microscopic existence of an oddly shaped bacteria in the fluid biopsied from their stomachs. A pathologist at his hospital, Dr. Robin Warren, had also become aware of some of these findings while looking at the biopsy reports of Dr. Marshall’s patients. He notified Dr. Marshall of this and together, they started evaluating slides of his patients with gastritis and duodenal ulcers. Over and over again, they found the same results – proliferation of this bacteria in the tissues biopsied. They named the bacteria Helicobacter Pylori (helicobacter for the helical shape and pylori which relates to the stomach). Dr. Marshall and Dr. Warren postulated that this bacteria was the cause of the gastritis and ulcers in their patients and discussed their findings with the medical community. Many of their colleagues were not convinced and their theory was received with a fair amount of speculation and hesitancy. To validate his theory, Dr. Marshall decided to drink the gastric juices he obtained from one of his ulcer patients. Within a period of two weeks, he became extremely ill, with daily episodes of vomiting. With assistance from a colleague who scoped him, a fluid sample was sent for pathological analysis. There on the pathology slides was the confirmation of the same bacteria he had viewed in his own sick patients.

Moving forward 40 years, H. Pylori is now accepted as being the cause of over 90% of gastritis and duodenal ulcer cases, as well as the number one infectious cause of gastric cancers. For their groundbreaking discovery, Dr. Marshall and Dr. Warren were awarded the Nobel prize in 2005. 

H. Pylori infection is most widespread in Asia as well as some developing nations with an infection rate estimated at about 80%, while in the US the infection rates are around 20-30% in comparison. In the US, it is most commonly found in the Hispanic and Native American populations followed by African American and white populations.

When an individual becomes infected with H. Pylori, the bacteria binds to the protective mucosal lining of the stomach and small intestine, thus weakening that lining and allowing acid the ability to penetrate the area beneath. This irritation of the membrane from the acid and the bacteria leads to gastritis, which can then lead to the development of “sores” or ulcers. These ulcers are most commonly found in the first part (the duodenum) of the small intestine connected to the stomach, but ulcers can also form within the stomach. If these ulcers are left untreated, they can lead to bleeding, perforations and gastric cancer.

H. Pylori is typically transmitted through food and from household contacts that are infected. One study showed a correlation to a greater number of household members, to a higher chance of infection. Childhood is the period in which most common transmission occurs, but most childhood cases are asymptomatic and more widespread than once believed. Since a large portion of patients with H. Pylori infections are asymptomatic, treatment is typically reserved for those who present with symptoms.

Symptoms of H. Pylori infection include:

● Burning sensation or pain in the stomach

● Stomach pain that is worse when stomach is empty

● Nausea and vomiting

● Loss of appetite

● Bloating and belching

● Unintentional weight loss

● If a bleeding ulcer is present, there may be blood in stool or black/tar colored stool

When to Seek Medical Advice:

If you’re experiencing any of these symptoms it’s important to speak to your doctor so they can rule out potential other causes such as NSAID induced gastritis and ulcerations.

If your doctor suspects an H. Pylori infection, the most effective method of detecting it is through a stool antigen test. A secondary method, a breath test, is also available.

Currently, the consensus is that only symptomatic cases are to be treated. The most common treatment option is a combination of two antibiotics, clarithromycin (Biaxin)and amoxicillin (Amoxil) with a proton pump inhibitor such as Lansoprazole (Prevacid).

It is also sold as a triple regimen called a Prevpac HP Pac that contains the proton pump inhibitor and two antibiotics in one pack.

Some natural therapies which have been shown to have some efficacy in treating H. Pylori include the probiotic strain Saccharomyces boulardii Saccharomyces Boulardii in Helicobacter Pylori Eradication in Children: A Randomized Trial From Iran – PMC as well as cranberry juice. Addition of cranberry to proton pump inhibitor-based triple therapy for Helicobacter pylori eradication – PMC

If you believe you may have contracted an H.Pylori infection, it’s important to speak with your doctor right away to get tested and treated to prevent long term complications.

References:

https://www.cancercenter.com/community/blog/2022/03/what-is-h-pylori

https://www.discovermagazine.com/health/the-doctor-who-drank-infectious-broth-gave-himself-an-ulcer-and-solved-a-medical-mystery

https://www.nobelprize.org/prizes/medicine/2005/press-release/