Ulcers

HELICOBACTER PYLORI AND ULCERS

Helicobacter pylori, or H. pylori for short, is a spiral-shaped bacterium which lives in the mucus lining of the stomach. Research shows that the bacteria, (along with acid secretion) damage stomach and duodenal tissue, causing inflammation and ulcers. Once the H. pylori bacterium has been eradicated with antibiotics and other medicines, peptic ulcer disease can be cured! Although it’s not certain how H. pylori is acquired, the chances of getting it become greater as you get older. At least 20% of the U.S. population is infected with H. pylori.

What causes ulcers?

For almost a century, doctors believed lifestyle factors such as stress caused ulcers. Later, researchers discovered that an imbalance between digestive fluids (hydrochloric acid and pepsin which are made by the stomach) and the stomach’s ability to defend itself against these powerful substances resulted in ulcers. More recently, medications such as aspirin and certain forms of arthritis medications have been shown to contribute to the formation of ulcers. Today, researchers shows that most duodenal ulcers and many cases of gastritis develop as a result of infection with the bacteria, H. pylori. While all four of these factors-lifestyle, acid and pepsin, certain medicatiosn, and H. pylori-play a role in ulcer development, H. pylori is now considered the primary cause of duodenal and many gastric ulcers.

What are the symptoms of ulcers?

The most common ulcer symptoms is gnawing or burning in the abdomen between the breastbone and the navel. The pain often occurs between meals and in the early hours of the morning. It may last from a few minutes to a few hours and may be temporarily relieved by eating or by taking antacids. Other ulcer symptoms may include gas, nausea or bleeding.

How are ulcers diagnosed?

The National Institutes of Health has emphasized the importance of adequately diagnosing ulcer disease and H. pylori before starting treatment, because treatment could be quite different depending on whether the ulcer is related to H. pylori or due to other factors. (Over 92% of duodenal ulcers and 70% of stomach ulcers are H. pylori related.)

Currently, doctors have a number of options available for diagnosing ulcers, such as performing endoscopic and x-ray examinations and testing for active H. pylori infection with simple non-invasive means including blood tests and simple breath tests.

We are proud to announce that Gastrointestinal Associates has been selected as the first GI practice in the country to begin testing with the recently approved breath test for the diagnosis of H. pylori.

How are ulcers treated?

Until now, acid-suppressing drugs known as H-2 blockers were the treatment of choice. You may recognize the names of some of them-Tagamet, Zantac, Axid, Pepcid, Prilosec and Prevacid. These drugs reduce the amount of acid the stomach produces by blocking histamine, a powerful stimulant of acid secretion. Unfortunately, these medications only reduce the acid, and do not treat the H. pylori infection. Therefore, ulcers recur in 50 to 80 percent of cases, necessitating maintenance therapy which can last for years or a lifetime and be extremely expensive.

The discovery of the link between ulces and H. pylori has resulted in a new treatment option. Now, in addition to treatment aimed at decreasing the production of stomach acid, doctors may prescribe antibiotics for patients with H. pylori. This treatment is a dramatic medical advance because eliminating H. pylori means the ulcer may now heal and most likely will not come back. Cure rates up to 90% have been reported by doctors after effective treatment of H. pylori!

What are the complications of ulcers?

If left untreated, ulcers can result in continued pain and discomfort and even more serious complications such as bleeding or perforation or narrowing of the esophagus or outlet of the stomach.

Recent studies have shown that H. pylori may be associated with the development of gastric lymphoma and even possibly with gastric cancer. Therefore identification of this organism in the stomach of certain individuals may be very important.