Helicobacter pylori is a gram-negative bacterium that can lead to many diseases of the upper gastrointestinal tract, including gastric ulcer, duodenal ulcer, and even stomach cancer. Find out what are the symptoms of Helicobacter pylori infection and what diet to follow during treatment. Why is Helicobacter pylori dangerous to humans?
Helicobacter pyloriprobably has been with man from the beginning of his existence. The bacterium is native to East Africa and began to spread about 60,000 years ago as humans moved to other areas. It was not until the end of the 19th century that the first scientific mentions of Helicobacter appeared, and it was first described in detail by prof. Walery Jaworski in 1889. He concluded that bacteria may be a factor in gastritis, but met with criticism from the scientific community and the topic was long forgotten. The breakthrough in research on Helicobacter did not come until 1982. It is a very interesting story, showing the dedication of academics to their research. Barry Marshall was one of the scientists who managed to create a Helicobacter breeding farm. To prove the theory that the bacterium causes gastritis, he drank a suspension containing Helicobacter, and after a few days he felt nauseous and then vomited. Endoscopy confirmed acute gastritis, and a biopsy confirmed the presence of Helicobacter pylori.
What is Helicobacter pylori?
Helicobacter pylori is a gram-negative, spiral-shaped, rod-shaped bacterium with 4-6 cilia that allow it to move. Helicobater is a migratory bacterium that can travel from the mouth, through the esophagus and stomach, to the duodenum.Most often, however, it is found in the stomach .
Helicobacter is classified as a pathogenic bacterium, although in some situations it is harmless to humans. To a large extent, pathogenicity is influenced by the presence of specific genes in a given strain.
It is estimated that about50% of the world's population are carriers of Helicobacter . In developed countries, 20 to 60% of people are infected, and in developing countrieseven 100%.
Poland is one of the countries with a high infection rate.84% of adult Poles are Helicobacter carriers .
Is Helicobacter pylori easy to get infected?
Helicobacter is contagious. It's very easy to get infected through saliva, i.e. kissing, drinking from the same glass, using the same cutlery.
Other routes of infection include contact with gastric juices, vomit and faeces.
Helicobacter is most often infected:
- as a result of insufficient hygiene,
- as a result of inaccurate washing of tableware in places serving food,
- as a result of drinking from glasses that are only rinsed in water, not thoroughly washed (which is often the case in countries where public awareness of disease transmission is low),
- between partners and family members as a result of the exchange of body fluids in various daily home and intimate situations.
- The carrier of Helicobacter is also insufficiently purified and uncooked water.
Symptoms of Helicobacter pylori infection
The presence of Helicobacter in the digestive tract may not give any symptoms or manifest itself in such a way that it is difficult to tell that it is an infection with this bacterium. Some symptoms at the beginning are very difficult to combine with any gastrointestinal infection.
Symptoms of Helicobacter pylori infection include:
- frequent burping,
- feeling full in the stomach,
- loss of appetite,
- quick feeling of fullness during a meal,
- weight loss,
- nausea and vomiting,
- very strong weakness, even leading to fainting,
- high fever with vomiting, severe weakness and numbness of the limbs at the time of the onset of the disease.
Why is Helicobacter pylori dangerous to your he alth?
In the acidic environment of the stomach, part of the hydrophobic layer covering the surface of each Halicobacter bacteria is destroyed, allowing the bacteria to attach to the gastric epithelial cells.
Helicobacter has a number of mechanisms that make the immune system poorly able to fight it. The bacterium has a molecule similar to blood group proteins on its surface, it easily changes its genetic material and adapts to a changing environment, and produces an enzyme that protects it against the damaging effects of stomach acid.
Helicobacter produces toxins and enzymes that cause stomach inflammation and ulcers. It causes stomach cancer in a small number of carriers.
Helicobacter infection does not cause obvious symptoms in everyone, but you need to be alert to ailments related to overeating or food poisoning, such as epigastric discomfort and nausea. These are often the only symptoms of infection that we usually ignore.
Diseases caused by the presence of Helicobacter pylori in the digestive tract are :
- chronic gastritis- Helicobacter infection is the main cause of gastroduodenitis - conditions in which an inflammatory infiltrate is formed on the surface of the mucosa, leading to mucosa atrophy. Gastritis by colonization of bacteria is always but not always symptomatic.
- gastric and duodenal ulcers- In 1-10% of carriers, gastritis leads to gastric or duodenal ulcers over time. What exactly are ulcers? These are not growths, as some people think, but defects in the mucosa that extend to the muscle layer. Peptic ulcer disease is the most common disease of the gastrointestinal tract, and the ulcer is more often located in the duodenum than in the stomach. In addition to the presence of Helicobacter pylori, a factor increasing the risk of ulcer development is the abuse of non-steroidal anti-inflammatory drugs (i.e. ibuprofen, diclofenac, naproxen). Helicobacter pylori is responsible for 75% of duodenal ulcers and 70% of gastric ulcers. In treating this disease, eradication of bacteria is key.
- tumors- From 1 to 3% of Helicobacter carriers develop gastric adenomas, and less than 0.1% gastric lymphomas. The presence of Helicobacter pylori in the gastrointestinal tract doubles the risk of gastric cancer. On the other hand, neoplastic changes resulting from the presence of bacteria are not located in the duodenum. Helicobacter itself most likely does not cause the mutations that lead to cancer, but it does cause it through chronic inflammation in a given area of cells.
- diseases outside the gastrointestinal tract- The presence of Helicobacter pylori in the gastrointestinal tract is associated with iron deficiency anemia, vitamin B12 deficiency, idiopathic thrombocytopenic polycythemia, urticaria and rosacea.
How to detect Helicobacter pylori?
If Helicobacter is suspected, initial diagnosis can be made using over-the-counter platelet tests. You can buy tests that detect antigens in the blood and in the stool.
Blood and stool tests detect the presence of Helicobacter in the body . It can be done before treatment begins. A positive result confirms the infection, but a negative result does not rule out it 100%. Ifwe want to check if the treatment has worked, a stool test can be performed.The blood test is unreliablebecause the antibodies in the blood persist long after the bacteria have been eradicated.
Pharmacy tests are not recommended, however. Their diagnostic efficiency is not the best and the risk of error is high. We will obtain much more valuable results through professional methods. The most certain thing is to performgastroscopy with biopsy .
Taking a section of the epithelium from the gastrointestinal tract for testing allows you to assess the presence of inflammation and bacteria. A urea breath test is usually ordered before starting treatment. This is the most accurate non-invasive method for detecting the presence of Helicobacter.
The patient is given 13C-labeled urea, which the urease produced by Helicobacter bacteria breaks down into ammonia and carbon dioxide. The amount of carbon dioxide containing 13C in the exhaled air is converted into the amount of Helicobacter in the stomach.
Other diagnostic methods include:
- blood serology test,
- stool antigen test and
- PCR test from saliva or faeces.
Current recommendations say that Helicobacter should be eradicated from the gastrointestinal tract when detected, regardless of whether there are any signs of infection.
How to treat Helicobacter pylori - antibiotic therapy
Treatment of Helicobacter is always carried out with the use of antibiotics and usuallylasts 10-14 days .
There are several treatment regimens that are most effective:
- Proton pump inhibitor (PPI), e.g. omeprazole + 2 of the following antibiotics: clarithomycin, amoxycycline, metronidazole
- IPP + bismuth + 2 antibiotics, most often metronidazole and tetracycline
- IPP + 3 antibiotics: clarithomycin, amoxycycline, metronidazole
The effectiveness of eradication varies, depending on the Helicobacter strain and the method used.
The method with PPI and 2 antibiotics is 55% effective, and the bismuth method - 80%.
After treatment is complete, a breath test or gastroscopy should be performed to make sure that Helicobacter has indeed been eradicated.
The recommendations of 2016 indicate that the effectiveness of Helicobacter pylori eradication increases after the inclusion of the probiotic strains Lactobacillus reuteri and Saccharomyces (S.) boulardii in the therapy.Probiotics increase the effectiveness of treatment by 10-14%and reduce the side effects associated with taking a lot of antibiotics in combination with PPIs.
Helicobacter eradication is veryinvasive, it largely destroys the beneficial microbiota of the body, causing digestive and absorption disorders, nausea, vomiting and diarrhea. Also for this reason, it is worth combining it with probiotic therapy.
In addition to probiotics, lactoferrin may be another substance helpful in the eradication of Helicobacter. So far, its effectiveness has been demonstrated in mouse models.
Herbs and natural Helicobacter pylori treatment
Antibiotic therapy in combination with PPIs or bismuth is not the only available form of Helicobacter treatment, but it is certainly the best studied. The increasing resistance of bacteria to antibiotics, and therefore the decreasing effectiveness of treatment, are the incentives to search for therapeutics among plants.
There are several plants, herbs and spices tested for eradication of Helicobacter pylori, although most of the research available to date has been conducted in vitro. Certainly, it is worth including plant raw materials as an aid to antibiotic therapy, and properly selected plant extracts themselves can be an effective medicine.
Plant ingredients with scientifically proven activity against Helicobacter pylori are mainly flavonoids. They show antisecretory, anti-inflammatory, antioxidant and antihistamine properties.
The most commonly reported anti-Helicobacter substance is isoramnetin (3-methyl quercetin ether; a quercetin derivative from the flavonoid group).
However, other classes of compounds that are helpful in treatment are also mentioned:
- cytoprotective quinones,
- antisecretory phenolic glycosides,
- terpenoids
- and saponins showing anti-ulcer activity.
Plants that have been proven to inhibit the growth and fight Helicobacter pylori bacteria and to treat symptoms of infection are:
- Cistus laurifolius,
- oregano (Origanum vulgare, Origanum majorana, Origanum dictamnus),
- aloe (Aloe vera),
- ginger (Zingiber officinale),
- licorice (Glycyrrhiza glabra),
- chamomile (Anthemis melanolepsis),
- turmeric (Curcuma longa),
- omanowiec viscki (Dittrichia viscosa),
- konyza (Conyza albida, Conyza bonariensis).
The higher the concentration of bioactive compounds, the stronger the action against Helicobacter pylori. For this reason, it is advisable to use extracts, oils and strong plant infusions.
Diet with Helicobacter pylori
A diet with Helicobacter infection should reduce gastric symptoms, if any, and assist in eradication.
To reducedigestive system ailments, such as a feeling of fullness, acid belching or nausea, it is advisable to:
- eating small meals, not too cold and not too hot,
- avoiding very spicy, sour and fried foods due to possible irritation of the stomach walls,
- avoiding alcohol,
- stop smoking,
- avoiding stressful situations.
Food as a therapeutic agent for Helicobacter eradication is also of great importance. It seems most helpful to eat isothiocyanate-donating vegetables, mainly sulforaphane precursors, which include:
- broccoli,
- cauliflower,
- Brussels sprouts,
- cabbage
- or radish.
Isothiocyanates certainly reduce the risk of ailments and diseases resulting from Helicobacter infection, and in high concentrations they can destroy bacteria.
Sulforaphane in vitro at a concentration of 2 μg / ml destroys Helicobacter colonies, even those resistant to clarithomycin.
In one study, it was shown that broccoli sprouts administered to patients in the amount of 70 g / day (corresponding to 420 μmol of glucoraphanin) significantly reduced the amount of Helicobacter bacteria in the stomach, which was confirmed by respiratory and antigen tests from faeces.
Fruits with a high polyphenol content can be very helpful in eradication of Helicobacter:
- blueberries,
- black currants,
- red currants,
- blackberries,
- raspberries.
Their activity against Helicobacter was demonstrated in in vitro tests. Other food ingredients that may help to treat the infection are:
- antibacterial honey,
- oily sea fish,
- linseed,
- chia,
- linseed oil,
- olive oil,
- rapeseed oil,
- blackcurrant seed oil
- and grapefruit seed oil as a source of omega-3 fatty acids and antibacterial substances.
To sum up, during the treatment of Helicobacter, the daily menu should include:
- broccoli, cauliflower, radish, Brussels sprouts, kohlrabi, cabbage and other vegetables with a specific sulfur aroma,
- dark berries and juices from these fruits,
- honey, preferably not exposed to high temperature, so as not to reduce its antibacterial properties,
- sardines, herring, mackerel, wild salmon and other oily cold water fish,
- linseed and linseed oil,
- chia seeds,
- rapeseed oil and olive oil,
- blackcurrant seed oils andgrapefruit.
In addition, it is advisable to include larger amounts of probiotic (providing intestinal bacteria) and prebiotic (supporting the growth of intestinal bacteria) foods in the diet due to the extensive damage to the microbiome during antibiotic therapy used to treat Helicobacter pylori infection.