Helicobacter pylori infection rates in relation to age and social class in a population of Welsh men

Article Abstract:

Infection of the gastrointestinal tract with the bacteria Helicobacter pylori (H. pylori) is thought to play a causal role in the development of a number of disorders of the stomach and intestines, including gastritis (inflammation of the stomach), peptic ulcer disease (ulceration of the stomach or intestines) and possibly stomach cancer. Over 95 percent of patients suffering from duodenal ulcer, for example, have evidence of H. pylori infection. Not all infected subjects immediately develop gastrointestinal symptoms. It is of interest to know the prevalence of H. pylori infection in the population at large; however, most studies of infection rates in populations other than gastrointestinal disease patients have used selected groups of subjects such as blood donors or health care staff volunteers. To better ascertain the percentage of the population that suffers from H. pylori infection, a sensitive and specific assay (enzyme-linked immunosorbent assay for immunoglobulin G) to detect the presence of H. pylori was used on frozen blood samples from 749 randomly selected men between the ages of 30 and 75 living in South Wales. The overall prevalence of H. pylori infection was 57 percent. Age differences were seen: 30 percent of the subjects between 30 and 34 had evidence of infection, while 59 percent of the subjects over 45 were infected. There was an inverse relationship between social class and infection rate; subjects in the lowest social class were much more likely to carry H. pylori than subjects in higher social classes. The patterns of H. pylori infection are consistent with the patterns of peptic ulcer disease and stomach cancer seen in the general population, further supporting a link between bacterial infection and these diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Demographic aspects, Wales, Social classes, Social class, Helicobacter infections, Stomach cancer

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Helicobacter pylori: bridging the credibility gap

Article Abstract:

Bacterial infections of the stomach have been reported since the 19th century, but it has been only a short time since successful culture and identification of the particular bacteria was first carried out. The predominant bacteria found in stomach and upper intestinal biopsy specimens is Helicobacter pylori (HP), and there is a growing body of evidence that links this bacteria with a variety of gastrointestinal maladies, including chronic gastritis, duodenal and gastric ulcer, and non-ulcer dyspepsia (a nonspecific complaint of gastrointestinal discomfort associated with the digestion of food). Physicians, for the most part, remain polarized on the issue. Some completely endorse the notion that HP infection is a causative factor in all the aforementioned diseases; others point to the fact that antihistamine drugs (which suppress gastric acid secretion) are highly effective in treating most of these disorders while they have little or no effect on HP infection. The evidence for HP playing a causative role is most compelling in gastritis; in the other disorders, less convincing data have been presented. Although HP is sensitive to a wide range of antimicrobial treatments, using these agents alone has proven disappointing, with little improvement over placebo administration seen. There is evidence to suggest that combining antihistamine and antibacterial therapies may offer an advantage, but patient compliance decreases as the number of medications increases, so the benefit may be only theoretical. One instance in which antibacterials might be beneficial is in patients who have had more than two recurrences of ulcer following antihistamine treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Bacterial infections, Gastritis

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Effect of increasing Helicobacter pylori ammonia production by urea infusion on plasma gastrin concentrations

Article Abstract:

Duodenal ulcer is a condition in which the inner lining of the duodenum (the first portion of the small intestine) becomes inflamed, causing bleeding and pain; if untreated, the wall of the duodenum may perforate, a potentially fatal occurrence. Duodenal ulcer is caused by gastric acid eating through the mucosal barrier protecting the inner lining of the duodenum. Over 95 percent of duodenal ulcer sufferers are infected with the bacteria Helicobacter pylori (H. pylori). Many, if not all, H. pylori-infected individuals have high blood levels of the gastrointestinal hormone gastrin (which causes secretion of gastric acid); these elevated levels are immediately decreased when the infection has been treated. Metabolic byproducts (ammonium) emanating from the H. pylori may be responsible for the increased gastrin levels. To evaluate this, eight patients who had a duodenal ulcer in the past year and tested positive for H. pylori infection were given intragastric infusions of urea (which is broken down by the bacteria into ammonium). While this procedure caused a 15-fold increase in ammonium levels, it had no effect on blood gastrin. One month after eradication of the H. pylori infection, the same test was run. There was a similar increase in ammonium levels, and a similar failure to increase blood gastrin. These results indicate that bacteria-generated increases in intragastric ammonium levels do not raise blood gastrin levels by an appreciable amount. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Gastrointestinal diseases, Gastrin, Duodenal ulcer

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