Helicobacter Pylori

What is Helicobacter pylori (H. pylori)?

H. pylori is a spiral-shaped bacterium found in the stomach, which (along with acid secretion) damages stomach and duodenal tissue, causing inflammation and peptic ulcers.

How does H. pylori cause damage?

It is believed that H. pylori's shape and characteristics cause the damage that leads to ulcers.

Because of their shape and the way they move, the bacteria can penetrate the stomach's protective mucous lining where they produce the enzyme urease, which generates substances that neutralize the stomach's acids. This weakens the stomach's protective mucus, makes the stomach cells more susceptible to the damaging effects of acid and pepsin and leads to sores or ulcers in the stomach or duodenum (first part of the small intestine).

The bacteria can also attach to stomach cells, further weakening the stomach's defensive mechanisms and producing local inflammation. For reasons not completely understood, H. pylori can also stimulate the stomach to produce more acid.

What causes an H. pylori infection?

Researchers do not yet know what causes certain people to develop H. pylori-related symptoms or ulcers.

What are the symptoms of H. pylori-related ulcers?

The following are the most common symptoms of H. pylori-related ulcers. However, each individual may experience symptoms differently.

Soon after being infected with H. pylori, most people develop gastritis - an inflammation of the stomach lining. However, most people will never have symptoms or problems related to the infection. When symptoms are present, they may include the following:

• Dull, gnawing pain, which may:
  • Occur two to three hours after a meal.
  • Come and go for several days or weeks.
  • Occur in the middle of the night when stomach is empty.
  • Be relieved by eating.
• Loss of weight.
• Loss of appetite.
• Bloating.
• Burping.
• Nausea.
• Vomiting.

The symptoms of ulcers may resemble other conditions or medical problems. Consult your child's physician for a diagnosis.

How is H. pylori diagnosed?

In addition to a complete medical history and physical examination, diagnostic procedures for H. pylori may include the following:

• Blood tests - to identify antibodies that indicate the presence of the bacterium.
• Stool test - to identify the bacterium (antigen).
• Breath tests - to determine if carbon is present after drinking a solution that breaks down urea.
• Tissue tests - tissue removed during an endoscopy is used to:
  • Detect the presence of the enzyme urease.
  • Examine the bacteria that is present.
  • Start a culture test to grow more bacteria for examination.

Treatment for H. pylori ulcers:

Specific treatment will be determined by your child's physician based on the following:

• Your child's age, overall health and medical history.
• The extent of the disease.
• Your child's tolerance for specific medications, procedures or therapies.
• The expectations for the course of the disease.
• Your opinion or preference.

Treatment may include:

• Antibiotics to kill the bacteria.
• Medications to suppress acid production, including:
  • H₂-blockers - to reduce the amount of acid the stomach produces by blocking histamine, a powerful stimulant of acid secretion.
  • Proton pump inhibitors - to more completely block stomach acid production by stopping the stomach's acid pump - the final step of acid secretion.

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