Campylobacter (Helicobacter) pylori: is peptic disease really a bacterial infection?

Article Abstract:

The development of peptic ulcers results from an imbalance between acids and enzymes in the stomach and the protective mechanisms of the stomach lining. Healing of peptic ulcers may be achieved by suppressing the production of stomach acid, most notably with drugs which are antagonistic to the histamine 2 receptor. Nevertheless, most peptic ulcers will recur, indicating that the underlying basis for the disease has not been cured. Recently, the spiral-shaped gram negative bacteria Campylobacter pylori has come under suspicion as the causative agent for peptic ulcers. The hypothesis is that the bacteria may inhabit the layer between the gastric mucosa and the epithelium and render the mucosa more susceptible to acid damage. After considerable research, the bacteria has come to be regarded as a new genus of microorganism, and has been renamed Helicobacter pylori. A review of the medical literature indicates that H. pylori is always found in patients with type B gastritis, and almost certainly is the cause of this disorder. However, the role of H. pylori in the development of duodenal ulcer is less clear. It seems likely that the organism participates in the development of duodenal ulcers, but is not their sole cause. Duodenal ulcers may exist in the absence of H. pylori infection. Furthermore, duodenal ulcers occur primarily in men, while the bacterium shows no sexual preference. There are no data to suggest that H. pylori plays a causative role in the development of gastric ulcers. The prevalence of infection among patients with gastric ulcers differs little from the infection prevalence among healthy subjects of the same age. There have been no adequate studies on the effects of bacterial eradication on the recurrence of gastric ulcers. Although there has been some speculation that H. pylori may contribute to the development of ulcers resulting from treatment with non-steroidal anti-inflammatory drugs such as aspirin, a definitive answer has not yet been provided. While the relationship of H. pylori to gastritis is well established, any role of the organism in non-ulcer dyspepsia (painful indigestion) has yet to be demonstrated. While the eradication of H. pylori may be accomplished with bismuth salts in combination with antibiotics, the potential side effects of the treatment, and the likelihood of rapid reinfection suggests that other treatments are a better first choice. Much more needs to be learned about the role of H. pylori in the development of upper gastrointestinal disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Stomach ulcer, Duodenal ulcer

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Chronic alcoholic gastritis: roles of alcohol and Helicobacter pylori

Article Abstract:

Gastritis, an inflammation of the lining of the stomach, is found frequently in alcoholics, and is often accompanied by symptoms of pain, nausea, vomiting, gas, and bad breath. Whether gastritis is caused by alcohol or not is unknown, as some studies have shown that not all subjects given large volumes of alcohol will develop the condition. In recent years, evidence has mounted that infection of the stomach with the organism Helicobacter pylori will cause gastritis. A study of 18 alcoholics with gastritis was done to determine how frequent H. pylori infection was, and if eradicating the organism would improve their symptoms. Of the 18, 14 were found to have H. pylori present in biopsy specimens. These were further divided into two groups; 10 patients were treated for their H. pylori infections with a combination of bismuth subsalicylate and two antibiotics, amoxicillin and metronidazole. The other four served as controls, and were treated only with antacids. The 14 were hospitalized and alcohol-free for the course of therapy. In three to four weeks, the 14 underwent repeat biopsies of their stomachs. The 10 whose H. pylori infections were treated were found to be free of any evidence of gastritis and were free of symptoms, while the 4 who had been given only antacids still had evidence of significant gastritis as well as symptoms of gastritis. This study strongly suggests that H. pylori infection is the cause of the chronic gastritis often seen in alcoholics, and that treating the infection will often cure the symptoms. The role that alcohol itself plays has yet to be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Alcoholism

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Seroprevalence of Helicobacter pylori in Seventh-Day Adventists and other groups in Maryland

Article Abstract:

Helicobacter pylori is an organism that seems to be linked to the development of chronic gastritis and peptic ulcers, but it is not known how it is acquired. Studies have shown that slaughterhouse workers and veterinarians are more likely than others to test positive for exposure to H. pylori, suggesting that exposure to animals or raw meat might be a cause of infection. Seventh-Day Adventists do not eat any meat or shellfish, and therefore it would be likely that the prevalence of H. pylori would be lower in this group if exposure to meat is an important means of transmission. Two hundred sixty-two volunteers were recruited, including 94 Seventh-Day Adventists. No difference was found between vegetarians and non-vegetarians in the prevalence of H. pylori, suggesting that meat consumption is not a risk factor. Neither are dietary factors such as alcohol and caffeine, since Seventh-Day Adventists consume neither. Prevalence was also not affected by sex, location (urban or rural), prior military service, or recent travel. Thirty-five percent of the volunteers tested positive for H. pylori infection; however the rate among blacks was 57 percent, compared with 26 percent for whites, with greater differences occurring among the younger groups. Evidence of infection increased with age, with about 90 percent of blacks affected by the time they were in their forties, an age when whites still showed a positive rate under 20 percent. This may be a result of socioeconomic differences, or certain racial and ethnic groups may be more susceptible to infection by H. pylori. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Demographic aspects, Helicobacter pylori, Seventh-Day Adventists

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