Stomach ulcer is a formidable disease, dangerous for its complications. Often gastritis with increased acidity of gastric juice serves as a precursor of an ulcer . In addition, as shown by the discovery of Australian scientists Warren and Marshall in 1983, stomach ulcers in many cases are caused by a bacterium in the form of a spiral – Helicobacter pylori (Helicobacter pylori). To put in place all those who do not believe and to prove the infectious nature of a stomach ulcer, one of the scientists publicly drank the contents of a bottle in which there were bacteria, and after a while he developed a stomach ulcer.  

Meet Helicobacter pylori, the causative agent of ulcers!

A distinctive feature of the Helicobacter pylori bacterium, in addition to the spiral shape, is the ability to survive in the acidic environment of the stomach. For this, the microbe has a number of adaptations. So, helicobacters live in the gastric pits under a thick layer of mucus, and while moving, they secrete the enzyme urease, which neutralizes hydrochloric acid around the bacteria. She also deftly “dodges” the immune system.

Another Helicobacter enzyme breaks down bactericidal substances secreted by immune cells into oxygen and water. Macrophages, on the other hand, cannot swallow it, because the bacteria, like an octopus – an ink stain, releases a cloud of ammonia. At the same time, as you know, there are plenty of nutrients in the stomach, and there is no competition, so all the conditions for a free life and reproduction have been deliberately created for the Helicobacter.

How Helicobacter pylori causes stomach ulcers: inflammation

About two-thirds of all Helicobacter bacteria are able to form vacuoles (vesicles bounded by a membrane) inside the epithelial cells of the stomach. From this, the cells die, and the wall of the stomach remains defenseless. In addition, ammonia has a detrimental effect on epithelial cells . 

Erosion forms in place of bare areas. This is not an ulcer yet, but, so to speak, their initial version. Helicobacter enzymes reduce the protective properties of gastric mucus. If Helicobacter lives in the stomach for a long time, then the body responds to a foreign object that cannot be destroyed with an inflammatory reaction. An ulcer on the stomach wall can be caused by certain substances associated with inflammation.

Since Helicobacter reduces acidity, the body believes that there is not enough acid, and begins to actively produce it. The inflammatory process also contributes to an increase in acidity. In addition, Helicobacter contributes to the production of pepsinogen, a precursor of the main enzyme in gastric juice, pepsin. In patients with H. pylori, the level of pepsinogen in the blood is often elevated.

How Helicobacter is infected

Helicobacter pylori refers to intestinal infections, which means that the route of transmission is fecal-oral. Nobody says that for infection you need to taste a known substance, but from the feces bacteria get into the soil and water, and from there onto vegetables, herbs, fallen fruits. Therefore, to avoid contamination, we need to thoroughly and often wash our hands, as well as wash everything that we receive from the beds, even if they brought it from the supermarket.

In a decent society, of course, it is not customary to relieve themselves on the street, but this is quite normal somewhere in India, and indeed, the prevalence of Helicobacter is higher where the socio-economic status is lower. It is also possible such a route of transmission – as poorly processed instruments used by doctors for gastroscopy and other procedures.

Helicobacter itself is unstable in the external environment. Therefore, most microbes die without finding a new home. However, some of them end up in cold water, where they can keep well for up to two weeks. If a person drinks unboiled water or, say, waters a garden with it, then he has every chance of accidentally swallowing a Helicobacter on his head. More precisely, not on the head, but on the stomach.

Not the most typical way, but you can also get infected with Helicobacter pylori from animals. Those who work with animals, such as in slaughterhouses, have higher levels of bacterial contamination. These bacteria live in the organisms of animals such as pigs, monkeys, as well as our closest friends – cats and dogs. Some studies show that Helicobacter survives well in the mouth and plaque, so in theory, you can get infected by kissing, using a common lipstick, and with any “bite off” cake or “let lick” ice cream.

How to Protect Against Bacterial Infection

In order not to pick up dodgy bacteria from family members or friends, it is enough to observe basic hygiene standards. In the end, this is not an airborne infection route, from which it is much more difficult to escape. And when touched, the Helicobacter is not transmitted. But, of course, the patient should have individual dishes and a towel, wash their hands after visiting latrines. Let us also remind you about washing vegetables and fruits, even “pure, pure” ones from our own garden.

Meanwhile, the infection can occur unnoticed during such actions, which we do automatically, without hesitation. For example, mommy licks a fallen nipple and gives it to the baby. Or, when feeding, he gives a spoonful of food to the child, and eats the spoon herself. What if he doesn’t eat otherwise? Just take two spoons!

Do all family members need to be treated for Helicobacter?

The whole family will only need treatment if they all have stomach ulcer symptoms. Usually, the patient’s spouse is recommended for treatment, since the risk of transmission and re-infection is very high. As already mentioned, pets – dogs and cats – can be carriers of Helicobacter pylori. In them, the infection proceeds as unnoticed for the carrier, as in humans, without causing any inconvenience. Although signs of stomach ailment may develop. The veterinarian decides whether to treat furry family members. By the way, after treatment (in humans) in 5-35% of cases, re-infection occurs within the first year, although it is possible that this is not a new infection, but an incomplete old one.

How to find out that there is Helicobacter in the stomach: antibodies

To begin with, if a person is tormented by symptoms of gastritis or stomach ulcers, or this diagnosis is made to him during gastroscopy, then there is a high probability that the bacteria have already settled in his stomach. However, this fact can be precisely established only with the help of special methods. They are invasive and non-invasive.

In the first case, during gastroscopy, a piece of mucous membrane is pinched off, and then they look under a microscope to see if there are bacteria there. Non-invasive tests include serological tests, when antibodies to Helicobacter are determined in the blood . But this method is suitable only before treatment, because antibodies remain in the body even after the destruction of Helicobacter in the stomach. In addition, it is not suitable for children whose antibody production is weak.  

The urease breath test has also been developed – an accurate and simple diagnostic method. The test is based on the ability of Helicobacter to secrete the enzyme urease and decompose urea into ammonia and carbon dioxide. The latter enters the exhaled air. The subject is given a test “breakfast” with carbon-13. And then the exhaled air is analyzed to detect carbon dioxide with carbon-13 in it. If the amount of carbon-13 increases by 5 ppm, the test is considered positive.

How is Helicobacter pylori treated: antibiotics

Eradication, that is, the destruction, of Helicobacter is included in the standard course of therapy for the diagnosis of gastric ulcer. Several schemes have been developed containing various antibiotics, bismuth preparations and agents that reduce the secretion of gastric juice, which significantly worsens the living conditions of bacteria. The regimen usually includes three or four drugs and lasts from 7 to 10 days. 

Also, eradication of bacteria is carried out after surgery for stomach cancer or if a relative has suffered stomach cancer, with gastritis with atrophy (thinning) of the mucous membrane, with some types of lymphoma. It is recommended to carry out a course of treatment for reflux esophagitis, when food from the stomach is easily thrown into the esophagus, causing heartburn, with functional dyspepsia and in diseases that require long-term treatment with non-steroidal anti-inflammatory drugs.